CMS IPPS 2014 Final Rule

Rebilling – Claims ImpactedClaims after the October 1 start date of IPPS:• “The claims for Part B inpatient and Part B outpatient services would have to besubmitted within the timely filing period [one year from date of service]. ”Page 50913, IPPSClaims subject to the Interim Rule 1455:• “The timely filing requirement in 414.5(c) will not supersede the Ruling’streatment of Part A claim denials to which the Ruling originallyapplied. Hospitals are permitted to follow the provisions in the Ruling regardingappeals and submission of Part B claims after the effective date of this final rule,provided (i) the Part A inpatient claim denial was one to which the Rulingoriginally applied, or (ii) the Part A inpatient claim has a date of admission beforeOctober 1, 2013 (the effective date of this final rule), and is denied afterSeptember 30, 2013, on the grounds that through inpatient services were notreasonable and necessary, hospital outpatient services would have beenreasonable and necessary.”Page 50935-50936, IPPS13