On August 2, 2013, the Centers for Medicare & Medicaid Services (“CMS”) published its highly anticipated 2014 Inpatient Prospective Payment System (“IPPS”) Final Rule (the “2014 IPPS Final Rule”). The 2014 IPPS Final Rule will be effective on October 1, 2013. There are two main aspects of the 2014 IPPS Final Rule that will significantly affect the day-to-day operations of hospitals nationwide: First, the 2014 IPPS Final Rule finalizes CMS’ proposal to revise its “Payment Denial Policy” and allow billing of many services under Part B following a determination that a Part A inpatient claim will be denied as not medically necessary. Second, the IPPS Final Rule changes the criteria for coverage of Part A of inpatient hospital claims.
The HLP has prepared a Client Alert outlining key provisions of this important rule.
For further information related to claims for inpatient hospital services and appeals of claim denials, please contact The Health Law Partners, P.C., attorneys Jessica L. Gustafson, Esq. or Abby Pendleton, Esq. at (248) 996-8510.