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No fee schedules, basic unit, relative values or related listings are included in CDT. The ADA does not directly or indirectly practice medicine or dispense dental services. When an individual is declared insolvent and his estate is sequestrated accordingly, it is not without consequences. Some of the consequences of sequestration will be dealt with herein below. All movable and immovable property of the debtor before and after the sequestration, fall within his insolvent estate.
The property which an insolvent thus acquired in the period between sequestration and rehabilitation, also forms part of his insolvent estate and is available for the payment of his debts, unless excluded in accordance with the Act. The insolvent is therefore divested of his property.
As stated earlier, this includes property which the insolvent obtained after being sequestrated, but prior to his rehabilitation. Such property may therefore be realised by the trustee and the proceeds distributed to creditors. Moreover, while the statute does not address whether Medicare will implement the suspension of sequestration based on the date of admission or date of discharge, because CMS originally implemented sequester in based on the date of discharge, it may use the same standard with respect to implementing the suspension of sequestration.
Medicare Advantage Reimbursement. In the Medicare Advantage program, the impact on provider reimbursement will depend on whether the provider has a contract with the Medicare Advantage plan, and if so, how the reimbursement language is phrased. As a result, sequestration applies to non-contracted Medicare Advantage fee for service reimbursement.
Due to short deadlines for appeal, it is important for providers to track non-contracted MAO reimbursement closely and set up processes to appeal expeditiously. Moreover, under the CMS Section Waiver on Hospital Operations and Reimbursement During the Coronavirus Pandemic, non-contracted providers may qualify to recover for services they provided during the period of the public health emergency directly from CMS.
This departure from the normal rule that CMS's liability in the Medicare Advantage program is limited to paying MAOs is intended to allow Medicare Advantage beneficiaries to receive necessary care from non-contracted providers and make additional provider funding available when they do during the relevant period.
Contracted Medicare Advantage : Whether or not sequestration applies in the context of a contracted Medicare Advantage arrangement depends on the specific reimbursement language in the contract. Related News. Am I likely to lose my home in sequestration? Are there any disadvantages to Sequestration? How does the Sequestration process start? How long does sequestration last?
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