CMS explains expedited determination process in Q&A
Rehab Regs, March 31, 2006
CMS posted a question-and-answer document on its Web site last week explaining the expedited determination process available to Medicare beneficiaries in swing beds, skilled nursing facilities, hospices, home health agencies, and comprehensive outpatient rehabilitation facilities.
The process makes it possible for these patients to obtain a review by a Quality Improvement Organization when their coverage ends, according to PT Bulletin Online.
The new guidance indicates that the expedited determination process is not triggered if a resident exceeds the Medicare therapy cap and fails to qualify for an exception.
To read the entire Q&A document, go to www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=164.
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