tci Medicare Compliance & Reimbursement - 2016 Issue 13

Inpatient Facilities: Welcome Clarity On Inpatient/Outpatient Status

However, whether beneficiaries will get more information of payment implications is still fuzzy. Denials for patients needing post-acute care may soon be a thing of the past thanks to the Centersfor Medicare & Medicaid Services’ (CMS’) proposed regulations to be incorporated in the Notice ofObservation Treatment and Implication for Care Eligibility (NOTICE) Act. Why it matters: Most beneficiaries to date still face the dilemma whether or not spending one night in the hospital makes them an inpatient. Patients sometimes are admitted as outpatients, kept on observation status, receive the requisite care, and then are denied Medicare coverage of...

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