In an effort to help clear the backlog of Medicare appeals, CMS has offered to pay hospitals 66 percent of the net allowable amount for short-term inpatient stays in exchange for hospitals dropping their pending appeals of denied claims.
Here are six things to know about CMS' offer.
1. Acute care hospitals and critical access hospitals are the only types of providers permitted to take part in the settlement process with CMS.
2. The settlement does not apply to any short-term hospital admissions that occurred after Oct. 1, 2013.
3. Claims subject to pending appeals before an administrative law judge or the Medicare appeals board are eligible for the settlement.
4. CMS will make the settlement process available Dec. 1. The deadline for hospitals to submit an Expression of Interest is Jan. 31, 2017.
5. CMS will host a call Nov. 16 to offer more details on the settlement process.
6. CMS made a similar offer to help clear the Medicare appeals backlog in September 2014. That settlement offer resulted in CMS paying nearly $1.5 billion to 2,022 hospitals across the nation.
More articles on healthcare finance:
Connecticut hospitals continue fight against hospital tax
8 changes to the Medicare Physician Fee Schedule in 2017
How CHS, Tenet, UHS, LifePoint and HCA fared in Q3