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UPDATED LINK: Participate in Medicare Advantage Experience Reporting Effort

NOTE: This updated email includes a new link to the MA Tracking Form. After tapping on the link, be sure to go to your Downloads folder for the file.

AHCA/NCAL, in collaboration with other long term and post-acute care provider organizations, is launching an effort to collect data on Medicare Advantage (MA) provider experiences, particularly related to prior authorizations and MA plan compliance with the CY2024 MA Final Rule (CMS-4201-F). Your participation is crucial in gathering insights on how these MA plans and regulations impact skilled nursing care.

We are specifically requesting data on your experiences with MA plans and prior authorization denials during the periods of August 18-31, 2024, and September 2024. This data collection will help us better understand the challenges providers face and advocate for necessary reforms.

Why is This Important?
The data collected will be used to analyze the effectiveness of the CY2024 MA Final Rule and its impact on beneficiary access to care. We will aggregate and share these findings with the larger MA Workgroup and use them to advocate for improvements to Medicare Advantage policies. This is particularly important in light of recent findings from a KFF analysis showing a record number of prior authorization denials by MA plans in 2022, with 3.4 million requests fully or partially denied.

How to Participate

  1. Download the MA Tracking Form: Complete the Excel tracking form (zip file) for the specified periods. Detailed instructions are included with the form. Be sure to go to your Downloads folder for the file.
  2. Submission: Email the completed forms to Martin Allen, Senior Vice President for Reimbursement Policy, by September 5, 2024 (for the August reporting period) and October 5, 2024 (for the September reporting period).
  3. Who Should Complete This? We recommend that facility administrators and business office managers handle the data compilation.

Confidentiality
Your responses will remain confidential and will not be attributed to specific facilities. The aggregated data will be shared within the MA Workgroup.

Please ensure that the appropriate staff review the reporting tool and understand the data collection process. If you need assistance or have questions, please contact Martin Allen directly.

Thank you for your support in this important effort.

 

Download the MA Tracking Form

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