Clarifying Medical Review of Hospital Claims for Part A Payment
Change Request (CR) 10080 clarifies the medical review requirements for Part A payment of short stay hospital claims (more commonly referred to as the "Two-Midnight" Rule) for MACs, Supplemental Medical Review Contractors (SMRC), Recovery Audit Contractors and the Comprehensive Error Rate Testing (CERT) contractors. (Note, such reviews are currently, mainly overseen by Quality Improvement Organizations).
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: May 12, 2017
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