Effect of Election of Medicare Advantage (MA) Organization

10.1.5.2 - Effect of Election of Medicare Advantage (MA) Organization and Eligibility Changes on HH PPS (Rev. 10758; Issued: 05-11-21; Effective: 01-01-22; Implementation: 08-11-21) If a Medicare beneficiary is covered under an MA organization during a period of home care, and subsequently decides to change to Medicare fee-for-service coverage, a new OASIS assessment must be completed, as is required any time the Medicare payment source changes. With that assessment, an NOA may be sent to Medicare to open an HH PPS period. If a beneficiary under fee-for-service receiving home care elects an MA organization during an HH PPS period of care, the period will end and be proportionally paid according to its shortened length (a partial period payment adjustment). The MA organization becomes the primary payer upon the MA organization enrollment date. .