← Glossary · CMS & regulatory
Continuation of benefits
Keeping a previously authorized service in place while the enrollee appeals its reduction, suspension or termination.
For DSNP-AIPs, CMS checks whether the plan continued benefits to enrollees who appealed a termination, suspension or reduction of a previously authorized service. Table 6 records whether the enrollee requested continuation of benefits (Column Q) and whether the benefits under appeal were provided during the plan-level appeal (Column R).
Source: ODAG protocol, Processing of Coverage Requests 2.7, PDF p. 14; Universe Table 6, Columns Q-R, PDF p. 44.