Hospitals Brace for Probe and Educate MAC Audits as Physician Documentation in Hospitals Takes on Even Greater Importance  

Category: Practice Management

Impact of the 2014 Inpatient Prospective Payment System ("IPPS") Final Rule on Hospital-Based Physician Documentation

Jessica L. Gustafson, Esq. & Abby Pendleton, Esq. | The Health Law Partners, P.C.

Introduction
On August 2, 2013, the Centers for Medicare & Medicaid Services ("CMS") released its 2014 Inpatient Prospective Payment System ("IPPS") Final Rule (the "Final Rule"), which was published in the Federal Register on August 19, 2013 (78 Fed. Reg. 50496 et seq.) and became effective on October 1, 2013. Some of the most significant aspects of the Final Rule are related to the importance of physician documentation, "clarifying" existing CMS documentation requirements; setting forth new CMS reimbursement criteria for Part A inpatient hospital claims; and establishing new guidelines to justify and document the medical necessity of Part A inpa...