Medicare AdvantageAdministrativeMedium impact
CMS Requiring New 90-Day Transition Period for Active/Current Treatments for Part C Drugs and Services Beginning Jan.1, 2024
Medical Mutual of Ohio·In the News
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Beginning January 1, 2024, CMS requires Medical Mutual to provide a 90-day transition period for new Medicare Advantage members to continue their active Part C drugs and services. Providers must initiate organization determinations before the 90-day period ends to prevent treatment disruptions.
Action Required
Before the end of each patient's 90-day transition period: Providers must initiate an organization determination request through Medical Mutual for any new Medicare Advantage members receiving active Part C drugs or services. Review the Policy and Standards section at MedMutual.com/Providers for specific procedures. Failure to initiate determinations will result in treatment disruptions after 90 days.