Tuesday, April 16, 2019

CMS Expands the Successful Formal Telephone Discussion Demonstration to Part A Providers Starting July 2019

Dan Ciolek

Recently, the Centers for Medicare and Medicaid Services (CMS) announced the expansion of the Telephone and Reopening Process Demonstration to the Part A East qualified independent contractor (QIC) jurisdiction. Effective on or after May 1, 2019, the Part A East QIC will offer telephone discussions and/or reopenings to providers within Medicare administrative contractor (MAC) Jurisdictions H, J, K, L, M, and N for all Part A claim types, except reconsiderations for service termination and hospital discharge reviews and claims or providers that are already involved in another CMS initiative (i.e., Settlement Conference Facilitation). If selected and offered a telephone discussion, provider participation remains voluntary under the expanded Demonstration. Current Demonstration activities conducted within DME MAC Jurisdictions will continue.

More information including a description of the demonstration and links to fact sheets are available here.

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