Medicare Part B Inpatient Billing in Hospitals Proposed Rule Fact Sheet ;reasonable and necessary;Medicare Part A claim denial;inpatient admission

CMS released a proposed rule, Medicare Program; Part B Inpatient Billing in Hospitals, which would revise the current billing policy under Medicare Part B following a denial of a Medicare Part A inpatient claim for services not reasonable and necessary. Specifically, the rule would allow payment for additional Part B inpatient services when a Medicare Part A claim is denied because the hospital inpatient admission was not reasonable and necessary, and would establish a permanent policy on a prospective basis once it is finalized.