Settlement split: CMS paid these hospitals nearly $1.5B to clear Medicare appeals backlog

A year after paying nearly $1.5 billion to 2,022 hospitals across the nation to help clear the backlog of Medicare appeals, CMS has identified the hospitals who shared in the settlement.

The backlog stemmed from hospitals appealing Recovery Audit Contractor decisions. In 2014, 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.

The $1.5 billion paid to the hospitals represented 346,000 claims, according to CMS.

NewYork-Presbyterian Hospital received the largest payment from CMS, amounting to $15.9 million to resolve 1,750 claims. Manhasset, N.Y.-based North Shore University Hospital ranked second, receiving $14.5 million to resolve 2,029 claims. Rounding out the top five were Chattanooga, Tenn.-based CHI Memorial Hospital ($10.9 million to clear 2,935 claims) Long Island Jewish Medical Center in New Hyde Park, N.Y. ($10.8 million to resolve 1,230 claims) and NYU Langone Medical Center ($10.5 million to resolve 1,199 claims). 

Although 35 hospitals were paid more than $5 million each, the median payment was $307,642, according to a Kaiser Health News analysis.

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