Under CMS’s modified inpatient admission guidelines adopted in the IPPS Final Rule, Part A payment is “generally inappropriate” unless the patient is admitted based on the physician’s expectation that ...
On September 5, 2013, CMS issued guidance concerning its new inpatient admission order and certification policies. As previously reported, CMS adopted new policies governing inpatient admissions, ...
Medical necessity determinations are not just a hot button issue with Recovery Audit Contractors RACs, but also with the other 'usual suspect' government auditors: Medicare administrative contractors ...
Hospital care can be complex and expensive. Strangely, a short hospital trip may cost more than an extended stay. In October 2013, Medicare enacted the “two-midnight rule” to discourage hospital ...
In American healthcare, Medicaid presents significant challenges, particularly regarding inpatient stay approvals. In recent years, Medicare and the Two-Midnight Rule have dominated discussions around ...
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