Responding to a proposed rule setting the fiscal 2014 inpatient prospective payment system, the Premier provider alliance is urging the Centers for Medicare and Medicaid Services to set a new payment policy for certain patients being held for observation.

“Specifically, CMS could establish a payment policy whereby a patient would be deemed an inpatient, even though a physician order is not on file, after 72 hours of observation services,” Premier suggests in an 83-page comment letter. “CMS would then pay hospitals a diagnosis related group payment for these ‘deemed-admitted’ patients and the inpatient deductible could apply to the patients. This is consistent with the existing policy whereby payments to hospitals for outpatient services provided within 72 hours of an admission are bundled into the DRG payment.”

Register or login for access to this item and much more

All Health Data Management content is archived after seven days.

Community members receive:
  • All recent and archived articles
  • Conference offers and updates
  • A full menu of enewsletter options
  • Web seminars, white papers, ebooks

Don't have an account? Register for Free Unlimited Access