News & Analysis as of

Medical Expenses Hospitals Medicare

Tyson & Mendes LLP

Shining Light on Phantom Medical Bills–Lessons from Washington on Using Federal Hospital Price Transparency Rules to Fight Back

Tyson & Mendes LLP on

How many of you reading this have had this experience: you get a settlement demand with hundreds of thousands of dollars in claimed hospital bills, but the actual amount owed by the claimant is redacted, or you are told by...more

Baker Donelson

IPPS Final Rule: CMS Addresses Allina Decision and Addresses New Medicare DSH Payment Calculations

Baker Donelson on

In the fiscal year 2014 Inpatient Prospective Payment System (IPPS) rule published in the Federal Register on August 19, 2013, CMS took two steps of note regarding the Medicare disproportionate share hospital (DSH)...more

Davis Wright Tremaine LLP

Trouble Ahead for One-Day Inpatient Stays: New Pre-Billing Challenges Loom

On Aug. 19, CMS published a final rulemaking that may effectively eliminate DRG Part A payments for most acute care inpatient stays of one day....more

Cozen O'Connor

Ruminations on Observation

Cozen O'Connor on

On July 29, 2013, the Office of Inspector General of the U.S. Department of Health and Human Services (OIG) released a memorandum report finding that Medicare paid more on average for short inpatient stays than for...more

King & Spalding

OIG Finds That Medicare Could Save Millions by Strengthening Billing Requirements for Canceled Surgeries

King & Spalding on

On August 6, 2013, OIG released a report with its findings that in a sampling of 100 hospital inpatient claims involving short-stay, canceled elective surgery admissions, 80 did not meet Medicare’s requirement that the...more

King & Spalding

CMS Releases FY 2011 SSI Ratios

King & Spalding on

CMS has released the FY 2011 SSI data for IPPS hospitals, LTCHs, and IRFs. This data will be used to determine the disproportionate share adjustment for hospitals and the low-income payment adjustment for IRFs for cost...more

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