 |
|
On May 22, 2025, the Centers for Medicare & Medicaid Services (CMS) announced that Medicare Administrative Contractors (MACs) will assume responsibility for conducting short stay inpatient hospital medical reviews and provider education (i.e. patient status reviews) to determine the appropriateness of Part A payment for short stay inpatient hospital claims beginning on or after September 1, 2025. These reviews were previously conducted by the Beneficiary and Family Centered Care (BFCC) Quality Improvement Organization (QIO) (BFCC-QIO). MACs will perform prepayment review of Medicare Part A claims as part of the Targeted Probe and Educate (TPE) program. On Wednesday July 30, 2025, 2 – 3 PM ET CMS will host an informational teleconference. This session will provide an overview of the transition and address questions from beneficiary and industry stakeholders. Stay tuned for an upcoming teleconference registration announcement and e-mail address to submit questions in advance. Provider Resources: |
|