Court Refuses CMS Request For Continued Delay In Hospital Medicare Appeals

On September 19, 2016, a federal judge denied the federal Centers for Medicare & Medicaid Services (CMS) request to stay enforcement of delays addressing a backlog of more than one million Medicare claims appeals lodged by hospitals since 2012. The hospitals are appealing claims for inpatient services billed under Medicare Part A that a Medicare Recovery Audit Contractor (RAC) said could have been treated in an outpatient setting and billed under Medicare Part B. After conducting a post-payment review, the RACs demanded that the hospitals return the Part A payments. The hospitals appealed the RAC denial to the CMS . . .