CMS is offering a new settlement deal for disputed billing denials, offering 66 cents on the dollar in exchange for hospitals dropping their appeals.
CMS outlined the settlement deal on its website and in slides posted online (http://go.cms.gov/2geW3DL). The offer began Dec. 1, 2016, and applies to acute care hospitals and critical access hospitals (CAHs) that have appeals at the administrative law judge (ALJ) and departmental appeals board (DAB) levels.
“CMS has decided to once again allow eligible providers to settle their inpatient status claims currently under appeal,” according to CMS. The new offer follows a 2014 deal that was intended to help clear a large appeals backlog. That deal settled about 346,000 disputed claims with 2,022 hospitals, but there still were more than 884,000 Medicare claims at the ALJ level for the federal fiscal year ending September 2015.