AHA yesterday urged the Centers for Medicare & Medicaid Services to rescind its recent audit determinations denying hospitals a mid-build exception to site-neutral payment under the 21st Century Cures Act. While the Cures Act required CMS to complete these audits before Dec. 31, 2018, the audits were completed and hospitals notified of the results more than two years after this date, resulting in inappropriately reduced payment rates for items and services furnished by certain off-campus provider-based departments that first billed Medicare for services furnished on or after Nov. 2, 2015, AHA wrote. 

“Specifically, providers that submitted mid-build exception requests must be excluded from the definition of ‘off-campus outpatient department of a provider’ in all instances where CMS has failed to timely render a contrary determination as part of a mid-build audit completed on or before Dec. 31, 2018,” wrote Tom Nickels, AHA’s executive vice president for government relations and public policy.
 

Related News Articles

Blog
Hospitals and health systems have long advocated for protecting patients from certain unexpected medical bills while preserving their access to care. The No…
Headline
AHA and 11 other organizations representing hospitals and physicians yesterday urged House and Senate committee leaders to include in the budget reconciliation…
Headline
The House yesterday approved by a vote of 220-212 a $3.5 trillion budget resolution, which included reconciliation instructions to provide the majority party…
Headline
AHA today raised “substantial concerns” with the prototype payment model that the Centers for Medicare & Medicaid Services, Department of Health and Human…
Headline
AHA today urged the Occupational Safety and Health Administration to withdraw its Emergency Temporary Standard for occupational exposure to COVID-19, or at…
Headline
AHA today shared with the National Economic Council, Federal Trade Commission, and departments of Health and Human Services and Justice an updated study by…