Select Medicare Advantage claims eligible for inpatient payment
Last update: October 2, 2023
Acute Hospital Care at Home
To help more members receive care at a time when many hospitals are overburdened, UnitedHealthcare is accepting the Centers for Medicare & Medicaid Services (CMS) Acute Hospital Care at Home program waiver for qualifying claims in the following benefit plans:
Medicare Advantage Special Needs plans, including Dual Eligible Special Needs (DSNP)
Group Medicare Advantage
Medicaid plans only if mandated by state law or regulations
Claims with a date(s) of service from Nov. 1, 2021 through Dec. 31, 2024 as outlined within the Consolidated Appropriations Act (CAA) signed into law on Dec. 29, 2022.
Please review the information below for details. If you have specific billing or claims questions, please contact your Provider Advocate or Network Engagement Manager.
The Acute Hospital Care at Home program was designed help more patients receive care at a time when many hospitals are overburdened due to the COVID-19 national public health emergency. To facilitate the goal of increasing hospital capacity and improving resource allocation, CMS waived a previous Medicare Conditions of Participation requirement. This allows qualifying hospitals to receive inpatient payment for providing acute inpatient level of care services to Medicare beneficiaries in their homes.