01 Feb
Posted by Admin, under: Debt Consolidation
Medicare Bad Debt on Rural Prospective Payment System (PPS) Hospitals. For the Office of Rural Health Policy, NORC completed a rapid response project examining the impact of the elimination of bad debts of Medicare reimbursement could have on rural prospective payment system (PPS), hospitals, and a component of the proposal of the President’s Fiscal Year 2007 (fiscal year) budget. Rural hospitals generally have a higher risk of delinquency, with a greater proportion of rural residents living below the poverty or without health insurance. In addition, rural hospitals tend to be too small to offer more lucrative services and programs that can offset the financial losses.
NORC simulate the financial effect of the elimination of bad debts repayment using data from 2005 and expenditure reports for 2005 Medicare inpatient PPS payment impact file. By comparing the total hospital Medicare reimbursement from 2005 to the estimates of reimbursement if the bad debt policy was not in place, NORC was able to calculate the percentage change in total Medicare reimbursements. Ten of 45 minutes of semi-structured interviews were conducted with hospital CFOs and CEOs to gather information about how these hospitals handle bad debt accounts and plans to make changes in response to policy changes. The quantitative analysis was accompanied by interviews to assess how the loss of reimbursement for Medicare bad debt and the change could affect rural hospitals EPA.
The study concluded that the elimination of bad debt reimbursement Medicare will adversely affect rural hospitals. Furthermore, although the beneficiaries of Medicare patients who appear to be most affected by the policy, other users of the hospital also suffer due to the decline in services such as hospitals may be forced to cut programs and services to stay afloat.
It has been the Centers for Medicare and Medicaid Services (CMS), the long-standing policy that when an account is in collection, a supplier may not have given the bad debt is and have not established that there is no risk of recovery under the regulations. That is, until the provider of a reasonable collection effort is completed, including both the activities and the use of a collection agency, a Medicare bad debt can not be regarded as uncollectible under section 310.2. Therefore, in accordance with regulations and policies in place before August 1, 1987, moratorium until a provider from the collection of reasonable efforts have been completed, including both the activities and the use of a collection agency unpaid deductible and coinsurance amounts can not be recognized as a Medicare bad debt.
If a Medicare contractor’s policy interpreted as August 1, 1987 to allow Medicare bad debt to get an account with a collection agency, then the implementation of the policy was not “in accordance with the rules in effect from August 1, 1987. ” Moreover, if a Medicare contractor in interpreting and applying the policy of August 1, 1987, which was not in accordance with the regulations in effect as of that date, and then, CMS has the ability to implement and expected to apply the correct policy.
Therefore, CMS has determined that all instructions issued earlier that has allowed the hospital Medicare claims for uncollectible accounts of a collection agency for Medicare on the basis of a contractor’s interpretation of the policy From August 1, 1987, are incorrect. In no case is an unpaid account that Medicare is in the collection, including a collection agency, bad debt allowable under the regulations. If a Medicare contractor has been the practice of allowing Medicare bad debts for some hospitals, while the accounts are in a collection agency, based on their practices as of August 1, 1987, the contractor Medicare reject these bad debts from the effective date of this memo / letter. However, the contractor should not reopen a Medicare cost reports for implementation of this policy.
It is the policy of Medicare does not reimburse hospitals and non-hospital providers for Medicare, while the bad debt of an account is a collection agency. Medicare contractors are responsible for making policy.