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Managed Care Companies Take Lead on PDPM Denials — But CMS Could Step
Up Scrutiny During 2021 |
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CMS largely left PDPM alone when it finalized the 2021 payment rule, and the agency has not been sending out additional documentation requests (ADRs) or denials related to the model. But that may not last forever, and managed care has provided a blueprint for claims scrutiny. |
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