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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