Medicare Initiates ‘3-Day Window’ Policy For Hospitals and Practices
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According to an article published in the American Medical News journal, the Supreme Court healthcare ruling allows Medicare to require hospitals and affiliated doctor offices to file modified forms for patients who are admitted within three days of visiting their physician.
The Medicare policy requires hospitals to notify their affiliated practices when a patient is admitted within three days of receiving care. Once the physician at the practice has been informed, he/she will be required to file a modified form that makes sure Medicare bills the patient the lower practice fee, not the hospital fee.
The article claimed that Medicare expected hospitals and affiliated practices to incorporate this policy by July 1, 2012, but those involved are behind in their adoption of the new process. American Medical Association President Peter W. Carmel, MD said Medicare should allow hospitals more time to meet policy requirements. Carmel claimed that hospitals are currently trying to create an effective line of communication with their affiliated practices, but there are several confusing aspects of the policy that are making it a slow process.
The new policy will create burdens on administration and delays on Medicare claims, said Medical Group Management Association President and CEO Susan Turney, MD. Turney stated that the relationship between hospitals and practices has been evolving recently and it is not necessary to have a policy that dictates the process of that relationship. According to the guidelines of the Medicare policy, any practice that does adhere to the policy will be penalized.
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