Corporate Compliance

Note: Further clarification on important changes to inpatient and outpatient hospital reimbursement under PPACA

Medicare Insider, July 20, 2010

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Editor’s note: Judith Kares, JD, CPC, regulatory specialist for HCPro, Inc., is the author of this week’s note from the instructor.

In a recent transmittal (R726OTN), CMS provided further clarification on changes to inpatient prospective payment system (IPPS) hospital reimbursement for FY 2010 and outpatient prospective payment system (OPPS) hospital reimbursement for CY 2010, as a result of the Patient Protection and Affordable Care Act (PPACA).  One of the more challenging aspects of implementing these changes is that they have various retroactive dates.   Going forward, payment is to be made based upon the updated rates, but instructions about how to handle past claims already paid under pre-PPACA requirements have yet to be issued.

Continue reading Judith's note on the MedicareMentor Blog.



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