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Resources: Medicare Credit Balance Reports, ABN Form Renewal, Utilization Management and more
Reminder: Medicare Credit Balance Reports Due
As a reminder, the Medicare Credit Balance Report for the quarter ending June 30th is due by July 30, 2023.
ABN Form Renewal
The Office of Management and Budget approved the Advance Beneficiary Notice of Noncoverage (ABN) (Form CMS-R-131 (ZIP)) and instructions (PDF) for renewal. You must use the renewed form with the expiration date of June 30, 2023, beginning August 31. There are no other changes to the form. Visit the ABN webpage for more information.
Click here to download Form CMS-R-131.
Click here to visit the ABN website.
New Kentucky Utilization Management Program
The Cabinet for Health and Family Services (CHFS) Department for Medicaid Services (DMS) has partnered with Gainwell Technologies to implement an automated prior authorization (PA) system for Nursing Facility Ancillary services. The automated PA system will offer a more efficient process that allows a member to begin treatment sooner and allows providers to receive a determination and start services much quicker.
All providers who submit PA requests will need to attend the training. Providers can register for virtual trainings at bit.ly/KYUMTraining. Providers will need to register for a free account and select Provider as your curriculum.
Tentative Go Live date is October 16, 2023.
Click here to view the memo from DMS.
Final MDS 3.0 Item Sets Version1.18.11 v4 Now Available
The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.18.11 have been updated and are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The IPA, NP, and SP Item Sets have been replaced with revised versions; the remaining item sets remain unchanged from the last posted version. The MDS Item Sets v1.18.11 will be effective beginning October 01, 2023.
Click here to view the MDS 3.0 Resident Assessment Instrument Manual.
