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2024 Final Rule: CMS Announces More Changes to Medicare Advantage but Declines to Reform the “60 Day Rule”

Health Care Law Brief

Determinations of medical necessity will need to follow national coverage determinations, local coverage determinations, or, where none are applicable, plans must follow publicly available, evidence-based coverage criteria. 2010) (quoting S. rather than a ‘limited duty to inquire.” See UnitedHealthcare Ins. Applications Int’l Corp. ,