CMS makes offer to clear Medicare appeals backlog: 6 things to know
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.
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