CMS proposes rule change to Part B billing

Description

Abstract: Earlier this year, the CMS issued a proposed rule that would allow hospitals to rebill Medicare for Part B services in certain circumstances after the denial of Part A inpatient admission for lack of medical necessity. The rule was released to address hospital complaints related to disputes over the difference between inpatient and outpatient care. The proposed rule provides some relief for hospitals but hasn’t stifled criticism of the CMS’s payment policies when claims for inpatient admission are denied. This article takes a close look at the rule, while a sidebar notes an interim rule that outlines more liberal Part B rebilling policies than in the proposed rule.