In November, the AHA and four hospitals — Missouri Baptist Sullivan (Mo.) Hospital, Munson Medical Center in Traverse City, Mich., Lancaster (Pa.) General Hospital and Trinity Health in Livonia, Mich. — sued HHS over denied Medicare payments from RACs. They alleged CMS seizes entire Medicare Part A inpatient payments from hospitals but “refuses” to disperse payment under Medicare Part B for most services, even though the agency agrees the care was reasonable and medically necessary.
According to the document, AHA contended CMS’ policies are invalid and requested an expedited briefing because “resolving this matter at an accelerated pace is essential.”
“Each day that CMS enforces the policy prohibiting full Part B payment following a Part A denial, hospitals lose hundreds of thousands of Medicare reimbursement dollars for medically necessary items and services they have provided to beneficiaries,” according to the motion. “This loss of revenue has real-world negative effects on the healthcare options available to everyone who needs hospital services.”
More Articles on AHA and RACs:
Medicare RAC Denials to Hospitals Climb 23% in 3Q
AHA Sues HHS Over Medicare Audits, Payment Denials
AHA to Host Webinars on Recovery Auditors
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