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Coalition: CMS’ Proposed Rule Disincentivizes Providers to Bill Medicare Properly and Accurately

 

FOR IMMEDIATE RELEASE
May 17, 2013

Coalition: CMS’ Proposed Rule Disincentivizes Providers to Bill Medicare Properly and Accurately

Rule threatens Medicare beneficiaries and Trust Fund solvency with ‘endless loop of rebilling’

Washington, D.C.The American Coalition for Healthcare Claims Integrity (ACHCI) today issued the following statement from spokesperson Becky Reeves after submitting comments to CMS on the Medicare Part B Inpatient Billing in Hospitals proposed rule (CMS-1455-P).

“After carefully reviewing the proposed rule, we are gravely concerned about the implications it could have for beneficiaries and the Medicare Trust Fund.

“The proposed rule seeks to placate hospital concerns about current audits for inpatient claims. Under the proposal, hospitals would be allowed to rebill for an expanded list of outpatient services when their claims for inpatient services are denied due to lack of medical necessity, thereby rewarding improper billing practices.

“Since 2009, auditors have been responsible for identifying and correcting nearly $5 billion in improper payments each year that are related to inpatient hospital claims. However, implementation of the proposed rule could result in an endless loop of rebilling, and cost Medicare billions of dollars each year.

“We urge CMS to take a closer look at the proposed rule and how it would affect not only the hospital industry, but also the solvency of the Medicare Trust Fund and its long-term ability to provide for the needs of American seniors.”

For more information, please visit: www.properpayments.com

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Read ACHCI Comments on CMS Part B Proposed Rule to learn more about this proposed measure and its impact on the Medicare Trust Fund.

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