CMS Reimbursement Rules

CMS Reimbursement Rules

The Centres for Medicare and Medicaid Services is a division that that was established in 1965 to administers the Medicare program and also provide Medicaid and health insurance programs. The centers for Medicare and Medicaid Services reimbursement rules for the “never events” needed a change in discharging patient care in inpatient establishments.

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The Centers for Medicare and Medicaid Services (CMS) rule that is in place today is adding conditions that are acquired within the hospital and that are not supposed to be paid for (United States & United States, 2005). This rule, therefore, gives more encouragement to upgrade the care given in the hospitals. Eight preventable conditions are known as the “never events.” These eight preventable conditions are not supposed to add on the disbursement (United States, 2012). That is, supposing a patient develops the conditions while they are staying in the hospital, they will not have to pay for the treatments of those conditions.

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In conclusion, there is a need for change in the Centre for Medicare and Medicaid Services reimbursement rules so that the doctors in charge can feel free to treat any patient in the hospital, therefore, ensuring that every patient within the hospital has equal chances of receiving treatments.

References

Farber, D. J., Scherb, E., &Practising Law Institute. (2017). Health care law Institute 2017: The new challenges facing providers – reimbursement, enforcement, compliance and other hot topics.

United States. (2012). Medicare physician payment: Private-sector initiatives can help inform CMS quality and efficiency incentive efforts: report to congressional requesters. Washington, D.C.: U.S. Govt. Accountability Office.

United States, & United States. (2005). Medicaid financing: States’ use of contingency-fee consultants to maximize federal reimbursements highlights need for improved federal oversight: report to the chairman, Committee on Finance, U.S. Senate.