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CMS Offers Settlement to Acute Care Hospitals and CAHs for Resolving Appeals of Patient Status Denials
Hospital Settlement

This MLN Connects™ National Provider Call provides details of the administrative agreement for acute care hospitals and critical access hospitals (CAHs) to expediently resolve appeals of patient status denials. To more quickly reduce the volume of patient status claim denials currently pending in the appeals process, CMS is offering an administrative agreement to any acute care hospital or CAH willing to withdraw their pending appeals (or waive their right to request an appeal) in exchange for timely partial payment (68% of the net payable amount). CMS encourages hospitals to make use of this administrative agreement mechanism to alleviate the burden of current appeals on both the hospital and Medicare system. The administrative agreement covers admissions prior to October 1, 2013. Administrative agreement requests are due to CMS by October 31, 2014. For details about the providers and claims eligible for administrative agreement, as well as the documents needed to request such an agreement, visit the Inpatient Hospital Reviews web page.

CMS encourages interested parties to submit questions in advance of the call. Submitted questions may be addressed on the call or may be used to create frequently asked questions (FAQs) that will be posted to the CMS website.

When: Tuesday, September 9, 2014

Time:    1:00 PM - 2:00 PM Eastern Time

Target Audience: Acute care hospitals, including those paid via the prospective payment system, periodic interim payments, and the Maryland waiver; and CAHs. A full definition of each of these facility types can be found at §1886(d) or §1820(c) of the Social Security Act.


  • Background
  • Which providers are eligible
  • What is the administrative agreement
  • How to submit a settlement request
  • Next steps
  • Answers to pre-submitted questions
  • Live Q&A

Call Materials:
Slide Presentation [PDF, 287KB]

Audio Recording [ZIP, 12MB]

Written Transcript [PDF, 289KB]

To register for an MLN Connects National Provider Call, please visit the CMS MLN Connects Upcoming Calls registration website.

Registration Assistance:

For More Information:
For more information, please visit the Inpatient Hospital Reviews web page.