The Centers for Medicare & Medicaid Services (CMS) on November 15 announced a new Part A to Part B Rebilling Demonstration Project, and the agency will begin accepting hospital applications today at 2 p.m. Eastern Time at the email addresses listed on page two the attached advisory. The project allows hospital participants to rebill certain inpatient denials as outpatient hospital claims for partial payment. Only 380 hospitals will be selected on a first-come, first-served basis to participate in the demonstration. Hospitals will be chosen based on bed size and location by region.
In order to participate in the demonstration project, hospitals must waive their appeal rights for all short stay claims that are denied because a CMS auditor determined the care should not have been provided in the inpatient setting.
The American Hospital Association has published a Regulatory Advisory reviewing the application process. If you are an MHA member and would like a copy, please email Shawn Rossi at srossi@mhanet.org. Please share this information with hospital leadership and RAC and clinical staff to determine whether your hospital should apply to participate in the rebilling demonstration project.
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