Providers have noted in recent weeks that CCME authorizations of continued services during Medicaid appeals appeared to be getting further and further behind, resulting in excessive delays in getting paid for MOS claims during appeals. Our investigation has determined that this occurred due to a breakdown of the MOS procedure for a period of time, because a staff member of a vendor company – whose job it was to handle appeals – went on leave, and no one was assigned to cover those responsibilities. According to DMA, this situation has now been corrected and the backlog of work is caught up, which should mean shorter delays for MOS authorizations in the new year.
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