To comply with a recent decision by the Centers of Medicare and Medicaid Services (CMS), Medicaid members whose authorization requests for inpatient services were denied now receive denial letters in the mail.
You can review an example of the letter here.
We wanted to make you aware in case your patients come to you with questions upon receiving a new letter. It’s important to note that there’s no change to liability for these denied services – the member won’t be responsible for additional charges beyond their normal emergency department and/or observation copays.