Dec 12 2023 1:00PM

Managed Care Final Rule

Significant progress to address and correct widespread managed care denials for coverage and payment were included in the CY 2024 Medicare Advantage final rule; and will be fully implemented by January 1, 2024. Changes require Managed Care Organizations (MCOs) to follow traditional Medicare coverage guidelines when making medical necessity determinations, limit prior authorization policies, and include the treating provider’s recommendation medical necessity determination.
Join this session to learn how to hold managed care insurers accountable to these new rules.

Objectives
• Detail new requirements for managed care organizations published in the MA Final Rule
• Identify best practices for addressing denied care and how to cite new requirements