CMS Issues Guidance Concerning Inpatient Admission Order and Certification Requirements


On September 5, 2013, CMS issued guidance concerning its new inpatient admission order and certification policies.  As previously reported, CMS adopted new policies governing inpatient admissions, including inpatient admission order and certification policies in its 2014 inpatient prospective payment system (IPPS) rulemaking.  The guidance, titled “Hospital Inpatient Admission Order and Certification,” attempts to clarify CMS’s newly espoused inpatient admission order and certification policies. 

The guidance addresses physician certification requirements, including the content and timing of the certification, the certification format, and the qualifications of the certifying physician.  In addition, the new guidance addresses inpatient order requirements, including the qualifications of the ordering/admitting practitioner, the use of verbal orders, the content and timing of admission orders, and the knowledge that a practitioner must have regarding a “beneficiary’s hospital course, medical plan of care, and current condition” in order to serve as the “ordering practitioner.”

To view the guidance click here

Reporter, Stephanie F. Johnson, Atlanta, +1 404 572 4629,

Topics:  Certifications, CMS, Healthcare, Patient Prospective Payment System

Published In: Health Updates, Insurance Updates

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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