Three-day Medicare payment rule could be expanded

Sen. Max Baucus (D-Mon.), chairman of the Senate Finance Committee, yesterday introduced a substitute amendment to the American Jobs and Closing Tax Loopholes Act (H.R. 4213) that would impact Medicare's three-day (aka 72-hour) payment rule for hospitals, in addition to extending Medicaid federal matching fund increases through June 2011 and further delaying Medicare physician payment cuts that became effective June 1, reports AHA News Now.

Currently, all diagnostic services provided on the day of admission and the three calendar days prior to admission must be bundled into the charges on a hospital's inpatient claim. The bill would prevent hospitals from unbundling services and submitting adjustment claims seeking separate and additional Medicare payments when they've determined that their original claims included unrelated services. Baucus projects that this provision will nip current practices in the bud to the tune of $4.2 billion.

To learn more:
- read this AHA News Now report
- read this RACMonitor article
- take a look at the amendment summary and legislative text

Suggested Articles

A select few legacy health organizations could thrive under a ‘Medicare for All’ system, according to a new analysis. 

The Congressional Budget Office estimates a Senate package tackling surprise billing and drug prices will save the government $7 billion.

Mahmee, a startup focused on maternal and infant health, just closed a $3 million funding round that includes Mark Cuban and Serena Williams.