May 13, 2011
Please be advised that as of July 1, 2011, CMS will no longer recognize exceptions to the ADvantage Cost Cap. Those exceptions to the Cost Cap, including one-time costs, temporary acute recovery care, hospice and institution transition costs will no longer be considered as exceptions to the total Service Plan costs.
Therefore, any Service Plan that is above the Cost Cap will no longer be approved. Those Service Plans that are currently over the Cost Cap due to exception provisions will be individually addressed.
The 2011 ADvantage Cost Cap is $40,471
If you are aware of any Members with an ACTIVE Service Plan that are presently over the current 2011 cost cap due to an exception , please contact the AAU at Provider Questions immediately to work with an AAU Representative.
If you have any questions or concerns regarding the information provided above, please feel free to contact us via email at Provider Questions.