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Article: Court Upholds Application of Payment-Reduction Factor to Part B Ancillary Services.
- Article from:
- Healthcare Financial Management
- Article date:
- July 1, 2001
- Author:
CopyrightCOPYRIGHT 2001 Healthcare Financial Management Association. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)
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On April 19, 2001, a Federal district court ruled that HCFA may apply a 5.8 percent payment-reduction factor in determining Medicare Part B payments to hospitals for ancillary services furnished to inpatients who are not entitled to Medicare Part A coverage. [a] Although the payment-reduction factor does not expressly apply to Part B inpatient ancillary services, the court concluded that the factor may reasonably be applied to those services, as well as hospital outpatient services, because HCFA has complete discretion to determine the extent to which payment should be made for such services under Part B.
Background
Medicare Part B generally covers ...