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CMS also noted that this change does not affect its requirements concerning which practitioners may issue inpatient admission orders.ĬMS adopted the change in the Final Rule in response to reports of claims for medically necessary admissions being denied as a result of “technical discrepancies with the documentation of inpatient admission orders,” such as missing or late signatures. According to CMS, this regulatory standard remains significant because it reflects a determination by the treating physician (or other qualified practitioner) that inpatient services are medically necessary. Notably, the Final Rule does not change the current standard in that same regulation that an individual becomes an inpatient when formally admitted under an order for inpatient admission by a physician or other qualified practitioner in accordance with that regulation and the conditions of participation for Medicare-enrolled acute care hospitals (CoPs) (42 C.F.R. § 412.3(a) to remove the current requirement that an inpatient admission order “must be present in the medical record and be supported by the physician admission and progress notes, in order for the hospital to be paid for hospital inpatient services under Medicare Part A.” As a result, starting October 1, 2018, CMS will “no longer require a written inpatient admission order to be present in the medical record as a specific condition of Medicare Part A payment.” Specifically, the Final Rule revises language in 42 C.F.R.
#CMS MUS2 OCT 2015 UPDATE UPDATE#
The Final Rule contains a number of important updates to Medicare Part A that take effect October 1, 2018.Īmong other provisions in the Final Rule, CMS finalized its proposed update of the regulations that govern hospital admissions under Medicare Part A (42 C.F.R. On August 17, 2018, the Centers for Medicare & Medicaid Services (CMS) published its Hospital Inpatient Prospective Payment Systems final rule for Fiscal Year 2019 (Final Rule).