On February 21, 2024, CMS published a transmittal on its website with instructions for Medicare Administrative Contractors (MACs) to implement CMS’s final rule, issued June 9, 2023, concerning the treatment of the Part C days...more
In a Federal Register publication last month, CMS announced that it intended to retroactively adopt a change to its Medicare disproportionate share hospital (DSH) regulation. Specifically, it proposed adopting a 2014 change...more
The Office of Inspector General (OIG) for the Department of Health and Human Services recently announced a new addition to its work plan: auditing whether payments made by Medicare for COVID-19 inpatient discharges billed by...more
On August 17, 2018, the Centers for Medicare and Medicaid Services (CMS) issued the FY 2019 Medicare IPPS final rule. Part of the rule modified the supporting documentation required under 42 CFR 413.20 to be submitted with...more
In the Inpatient Prospective Payment System (IPPS) rulemaking for fiscal year (FY) 2019, the Centers for Medicare and Medicare Services (CMS) announced that it would begin auditing the charity care and bad debt costs...more
On July 8, 2015, the Centers for Medicare and Medicaid Services (“CMS”) released a Proposed Rule regarding the 2016 Hospital Outpatient Prospective Payment System (“OPPS”). The Proposed Rule, in addition to proposing updates...more
In the 2016 inpatient prospective payment system (IPPS) proposed rule, CMS promised to provide further guidance on the controversial "two midnight" rule in the forthcoming outpatient prospective payment system (OPPS) rule....more
On August 2, 2013, the Centers for Medicare and Medicaid Services (“CMS”) released the final rule for the 2014 Medicare Inpatient Prospective Payment System (“IPPS”), effective October 1, 2013.[1] Introduced in the IPPS...more
On February 24, 2014, CMS released additional guidance addressing implementation of the revised inpatient hospital admission standards adopted in the 2014 IPPS Final Rule and new instructions to the Medicare Administrative...more
Probe and Educate Audits of Inpatient Admissions Extended - CMS announced on its Inpatient Hospital Review website on Friday that it was extending the probe and education audits of inpatient admissions for an...more
Centers for Medicare and Medicaid Services (CMS) finalized a new rule, effective October 1, 2013, under which hospital inpatient admissions are considered reasonable and medically necessary if the physician expects a...more
In early November, CMS released additional guidance regarding implementation of provisions of the 2014 Inpatient Prospective Payment System (IPPS) Final Rule that apply to inpatient admissions. For more background regarding...more