Critical Access Hospitals Center
Hospitals Appeals Settlement - Oct 9 Call/ Transcript and Recording of 9/9/14 Call
The audio, transcript , and presentation from the September 9 MLN ConnectsTM National Provider Call are now available. Visit the“Downloads” section at the bottom of the Inpatient Hospital Reviews web page to find the latest versions of the Hospital Settlement FAQs, Administrative Agreement, Hospital Participant Settlement Instructions, and Eligible Claims Spreadsheet. Bookmark this page as content will be updated and additional FAQs posted.
CMS will hold another MLN ConnectsTM Call on Thursday, October 9, from 1:30-3pm ET. Registration will open by Sept 19
- Additional Clarification of Guidance on the Physician Order and Physician Certification for Hospital Inpatient Admissions
On August 19, 2013, in the FY2014 IPPS/LTCH final rule CMS clarified and revised the conditions of payment for hospital inpatient services under Medicare Part A related to patient status. On September 5, 2013, CMS released guidance that discussed the provisions of the final rule regarding the physician order and physician certification of hospital inpatient services. This document includes further clarification of issues addressed in the previous guidance.
Prior Guidance on the Physician Order and Physician Certification for Hospital Inpatient Admissions
The guidance provided in this document has been further clarified in Additional Clarification of Guidance on the Physician Order and Physician Certification for Hospital Inpatient Admissions. This version of the guidance document will remain online for comparison purposes.
- New Materials Available for Hospital Outpatient Prospective Payment System Proposed Rule
CMS has posted corrected addenda, cost statistics files, an impact file, and an impact table for the CY 2014 Hospital Outpatient Prospective Payment System (OPPS) Proposed Rule (CMS-1601-P). These corrected files are available on the Hospital Outpatient PPS website. More information about the proposed rule is available on the Hospital Outpatient Regulations and Notices web page.
- Vaccination is the Best Protection Against the Flu [PDF, 414KB]
- CMS Rule 1599-F: Inpatient Hospital Admission and Medical Review Criteria (2-Midnight Provision) and Part B Inpatient Billing in Hospitals
CMS hosted a Special Open Door Forum (ODF) call to allow hospitals, practitioners, and other interested parties to give feedback on the physician order and physician certification, inpatient hospital admission and medical review criteria, and Part B inpatient billing provisions that were released on August 2, 2013 in the FY 2014 Inpatient Prospective Payment System (IPPS) final rule (CMS-1599-F). This introductory call allowed for initial discussions between stakeholders and CMS. The transcript and MP3 audio file will be posted to the Special ODF webpage under the "Downloads" section around August 22 and will be available for 30 days. CMS understands that providers or associations may have additional questions or concerns. You are encouraged to submit questions related to the two midnight provision for admission and medical review to the IPPSadmissions@cms.hhs.gov mailbox. Questions on Part B inpatient billing and the clarifications regarding the physician order and certification should be sent to the subject matter staff listed in the final rule. CMS will review stakeholder feedback as quickly as possible and provide responses and clarification as needed.
MLN Connects Provider e-News Spotlights
- Subscribe now to receive the weekly MLN Connects Provider eNews for the latest Fee-For-Service program information, event announcements, claims and pricer information, and MLN educational product updates.
- Physician Bonuses
- MLN Matters Article SE0453 [PDF, 67KB] : MMA-Proposed Implementation of the Physician Scarcity Bonus and Revision to the Health Professional Shortage Area (HPSA)
- Skilled Nursing Facility PPS
- Survey & Certification - General Information
- Critical Access Hospitals
- Form CMS-2802E - Request for Validation of Accreditation for Critical Access Hospital Survey
- MLN General Information
- MLN Educational Web Guides
- MLN Matters Articles ( Search Tips )
- MLN Products
- Physician Regulatory Issues Team (PRIT)
- Choosing to Convert to Critical Access Hospital Status -- Health Care Financing Review: Fall 2003 Edition Article
- Frequently Asked Questions - Opens in a new window
- Press Releases - Opens in a new window
- Internet-Only Manuals (IOMs)
- Claims Processing Manual - Chapter 4 - Part B Hospital (Including Inpatient Hospital Part B and OPPS) [PDF, 1MB] - Special Rules for Critical Access Hospital Outpatient Billing
- CMS Regional Office Rural Health Coordinators Updated July 2013 [PDF, 17KB]
- Quality Improvement Organizations (QIO)
- CMS Regional Offices
How to Stay Informed
Subscribe now to receive the weekly MLN Connects Provider eNews for the latest Fee-For-Service program information, event announcements, claims and pricer information, and MLN educational product updates.
- Hospitals Open Door Forum