Fed Regist. 2013 Mar 18;78(52):16614-7.
This notice announces a CMS Ruling that establishes a policy that revises the current policy on Part B billing following the denial of a Part A inpatient hospital claim by a Medicare review contractor on the basis that the inpatient admission was determined not reasonable and necessary. This revised policy is intended as an interim measure until CMS can finalize a policy to address the issues raised by the Administrative Law Judge and Medicare Appeals Council decisions going forward. To that end, elsewhere in this issue of the Federal Register, we published a proposed rule entitled, "Medicare Program; Part B Inpatient Billing in Hospitals,'' to propose a permanent policy that would apply on a prospective basis.
本通知宣布了一项医疗保险和医疗补助服务中心（CMS）的裁定，该裁定确立了一项政策，即修订当前关于B部分计费的政策，此修订是在医疗保险审查承包商基于住院入院被判定为不合理且不必要而拒绝A部分住院医院索赔之后进行的。这项修订后的政策旨在作为一项临时措施，直至CMS能够最终确定一项政策，以解决行政法法官和医疗保险上诉委员会未来裁决所引发的问题。为此，在本期《联邦公报》的其他地方，我们发布了一项名为“医疗保险计划；医院B部分住院计费”的拟议规则，以提议一项将前瞻性适用的永久性政策。
