As Anticipated, Public Health Emergency (PHE) Determination Extended Into 2023

Effective October 13, 2022, the U.S. Department of Health and Human Services renewed the PHE determination for 90 days. This renewal means 3-Day Qualifying Stay and Benefit Period Waivers have been extended through January 12, 2023. To prepare for post-pay audits, providers should ensure supportive documentation is captured when using available SNF 1135 waivers. Celtic … Continue reading

Post-Pay Reviews Start for SNF Claims Using 3-Day Stay Waiver

Post-pay auditing has begun for skilled nursing facility (SNF) claims which utilized the 3-Day Stay Waiver allowed by the Centers for Medicare and Medicaid Services (CMS) in response to the public health emergency (PHE). Providers who used the waiver to cover in-house residents are most at risk for audit. Noridian, as the national Supplemental Medical … Continue reading