CMS Offers Partial Concession to Hospitals by Issuing Ruling, Proposed Rule on Part B Re-Billing

Caron, Jason B.; Isbey, Elizabeth K.; Polacheck, Joan; Zimmerman, Eric
January 2013
Venulex Legal Summaries;2013 Q1, Special section p1
The article reports on the U.S. Centers for Medicare & Medicaid Services' (CMS) release of both a ruling and a proposed rule to address the growing concern among hospitals about billing Medicare Part B following a medical necessity denial of a Medicare Part A hospital inpatient claim. The rules provide temporary and partial concession to the hospital community, but fell short of hospital expectations. Hospital are advised to assess their recovery audit contractors (RAC) appeals strategy.


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