Case Review Connections
A Newsletter for Healthcare Providers and Stakeholders
Acute Care Edition/Post-Acute Care Edition
Issue 41: August 2024
Medical Director's Corner
Written by Jessica Whitley, MD, MBA
Acentra Health recently started our 13th Scope of Work with the Centers for Medicare & Medicaid Services (CMS) on May 1, 2024. As part of this new work, CMS has tasked Acentra Health with collaborating with healthcare facilities to ensure Medicare beneficiaries with Original Medicare and their representatives understand their discharge plans. Acentra Health will now offer Immediate Advocacy assistance for discharge planning when a Medicare beneficiary or representative calls Acentra Health to file a hospital discharge appeal. Some hospital discharge appeals are filed due to concerns with discharge planning rather than medical concerns about the discharge. To address this issue, Acentra Health will work with facilities to ensure that Medicare beneficiaries clearly understand their discharge plans while continuing with the discharge appeal process. If discharge concerns are resolved, beneficiaries may request that the appeal be stopped, and Acentra Health will consider the appeal resolved and will inform the hospital.
All of our other services will remain the same as in the previous scope. Our phone numbers have not changed, and we will continue to be the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) for 29 states in CMS Regions 1, 4, 6, 8, and 10.
Further information about this new Immediate Advocacy Discharge Assistance process can be found on our provider appeals webpage.
Acentra Health Update
Providing the same services, but with a new name and look, there are no changes that will impact the work you have come to expect from our company.
Acentra Health is the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) for the same regions. We are happy to let you know that we will continue to perform our Medicare contracted reviews through 2029.
Since the only difference is our name, you can rest assured that our phone and fax numbers have not changed, and you will still have access to all the tools you need to fulfill your duties. We will have an updated website, but the Case Status tool will still be available, and access will not be disrupted.
We encourage providers to update their notices – the Important Message from Medicare (IM) and the Notice of Medicare Non-Coverage (NOMNC) – by changing “Kepro” to “Acentra Health” when convenient for your organization. However, it is important to know that notices will not be made invalid if they have “Kepro” listed.
Publication No. R146810-68-08/2024. This material was prepared by Acentra Health, a Medicare Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy.
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If you want to communicate BFCC-QIO information, please email Acentra Health at QIOCommunications@acentra.com and request a newsletter insert or fact sheet for your organization. Please do not copy and paste information from Case Review Connections.
Webinar: August 28, 2024
- 2 PM ET
Unlocking Insights: Exploring Medicare Skilled Nursing Facility (SNF) Appeal Trends And Lessons Learned
The webinar will include the following:
- Review BFCC-QIO appeals trends from the SNF setting
- Discuss potential drivers of noted trends
- Identify issues that may impede access to care and compromise quality of care
- Discuss opportunities to improve beneficiary care and/or the documentation of that care in the SNF setting
This webinar is intended for the SNF community.
Register Now