Many case management and finance departments have been busy with appeal activities since CMS resumed its regulatory audits on August 3, 2020. Utilization review (UR) nurses are reporting increasing numbers of commercial denials as the coronavirus (COVID-19) pandemic is resolving.
This week’s Medicare updates include proposed rules for the inpatient psychiatric facility prospective payment system, skilled nursing facility prospective payment system, and the hospice payment rate update.
CMS should rescind denials recently issued to certain off-campus provider-based departments (PBD) that applied for the mid-build exception under the 21st Century Cures Act, the AHA said in a March 25 letter to CMS.
