A Closer Look Into Medicare Part B Inpatient Billing

Law360, New York (April 24, 2013, 1:23 PM EDT) -- On March 13, 2013, the Centers for Medicare & Medicaid Services (CMS) concurrently issued  CMS Ruling Number CMS-1455-R and a proposed rule, “Part B Inpatient Billing in Hospitals."[1] The administrator's ruling and proposed rule address the submission of Medicare Part B inpatient claims where a Medicare Part A claim for a hospital inpatient admission is denied by a Medicare review contractor on the grounds that the inpatient admission was not “reasonable and necessary.”

The proposed rule also would apply to situations where a hospital determined, through...
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