CMS to resume Medicare appeals settlements

Ayla Ellison -

CMS announced Thursday it will again allow eligible hospitals to settle inpatient status claims currently under appeal. 

CMS said details about the settlement process will be released in the near future.

CMS first offered hospitals the chance to settle Medicare appeals in 2014. At that time, CMS offered to pay hospitals 68 percent of the net payable amount for short-term inpatient stays in exchange for hospitals dropping their pending appeals. Claims that occurred prior to Oct. 1, 2013, and were pending appeal — including claims where an administrative law judge had ruled against a hospital, and the hospital was appealing to a higher level — were eligible for the settlement.

CMS executed settlements with 2,022 hospitals, representing approximately 346,000 claims. CMS paid the hospitals a combined total of approximately $1.47 billion to settle the claims.

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