United States: Hospitals Face Important Decision On Whether To Accept CMS Settlement Offer For Certain Claims On Appeal

Hospitals Can Settle Certain Claims Now for 68 Percent of Their Value

The Centers for Medicare and Medicaid Services (CMS) recently announced a policy allowing acute care and critical access hospitals to settle inpatient-status claims currently on appeal in exchange for a partial payment equal to 68 percent of the claims' net allowable amount. The claims eligible for the settlement are those that were billed on an inpatient basis but, according to Medicare contractors (particularly the RACs), should have been billed as outpatient or inpatient Part B claims. Claims that have been denied for a reason other than "patient status" are not eligible for the settlement.

* This article was originally published in the Health Care Counsel blog. To read it in its entirety, click here.

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