CMS IPPS 2014 Final Rule
CMS IPPS 2014 Final Rule
CMS IPPS 2014 Final Rule
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Rebilling EvolutionPrior to New Rulings Interim 1455 <strong>CMS</strong> <strong>Final</strong> <strong>Rule</strong>Self AuditingBill Part B Ancillaries only.Subject to limitations of CC44Allows providers to rebill only forclaims denied by a MedicarecontractorAllows providers to rebillinpatient Part A claimsdenied as a result of a “selfaudit”Part B RebillingOnly allowed if Judgedetermined appropriate. NoregulationsRebilling of covered Part Bcharges when the Part A claim isdenied as not medicallyreasonable and necessaryPart B rebilling to claims forservices rendered tobeneficiaries enrolled inMedicare Part BTimeliness forRebillingOnly if within timely filing(one year) or Judge orders(no time limit)Allows for rebilling 180 days fromdenial or lost appeal with date ofservice before Sept 30, 2013Standard timely filingrequirements (1 year fromthe date of service) onrebilled claimsImpact toBeneficiaryTo be held harmlessUpon rebilling, requires hospitalto adjust beneficiary billingUpon rebilling, requireshospital to adjust beneficiarybilling40
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