MEDICARE ADVANTAGE AND THE 2-MIDNIGHT RULE IN 2024

Wednesday, November 29, 2023 | 2:00 - 3:00 pm ET

The date for the CMS Final Rule (CMS-4201-F) on Medicare Advantage Plans (MAP) is approaching fast. The final rule published 4/15/2023 goes into effect on 1/1/2024. Are you ready? This is the rule that reinforces the expectation from CMS that MAPs follow the 2-midnight rule that has been in place for traditional, Fee-for-Service (FFS) Medicare for 10 years. The Final Rule also reinforces the expectation for MAPs to adhere to the inpatient-only procedures list. What is your team doing to prepare?

Join us as we discuss the specifics of the Final Rule that apply to MAPs, the 2-midnight rule, the inpatient-only list, and denials and appeals. We’ll discuss what you need to do now to ensure your team is ready for the new rule. Special attention will be given to how to monitor and report MAP compliance with the new rule. We can’t level the playing field if we aren’t all following the same rules.

ABOUT THE PRESENTERS:

Denise Wilson, MS, RN, RRT, Senior Vice President, PayerWatch + AppealMasters, President, AHDAM

Denise has over thirty years of experience in healthcare, including clinical management, education, compliance, and appeal writing.

Denise has extensive experience as a Medical Appeals Expert and has personally managed hundreds of Medicare, Managed Medicare, and Commercial appeal cases and presented hundreds of cases at the Administrative Law Judge level. Denise is a nationally known speaker and dynamic educator on Medicare and Commercial appeals processes, payer behaviors, standards of care, appeal template development, and building a road map to drive the payer to a decision in the provider’s favor. She has educated thousands of healthcare professionals around the country in successfully overturning healthcare denials.

Kendall Smith, MD, Chief Physician Advisor, PayerWatch + AppealMasters 

Dr. Kendall Smith is a Senior Fellow in Hospital Medicine (SFHM) and currently acts as Chief Physician Advisor for AppealMasters, a leading appeal educator and appeal services firm for hospitals and health systems. He’s been deeply involved in denial and appeals management throughout his hospitalist career, working collaboratively with UR/Case Management departments as well as Managed Care and Hospital C-Suite executives.

His familiarity with managed care denials led him to design and implement a number of CDI programs, including those at the Cleveland Clinic in Florida and the MedStar Washington Hospital Center. He has served as a physician leader on hospital revenue cycle management teams while also serving as a Physician Advisor for Clinical Resource Management. Dr. Smith is also an AHIMA ICD-CM/PCS approved trainer/ambassador.

REGISTER NOW

You must register with a business or provider email address. General email accounts such as Gmail or yahoo will not be approved for attendance. CEU's are for AHDAM members only.