2024 Final Rule: CMS Announces More Changes to Medicare Advantage but Declines to Reform the “60 Day Rule”
Health Care Law Brief
APRIL 12, 2023
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. 3729(b)(1)(A) of the False Claims Act (“FCA”). See Proposed Rule at 79559. See 42 U.S.C.
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