Long-Term Care Hospitals Denied $3 Million in Bad Debt Payments

Aug. 10, 2021, 6:02 PM

A group of long-term care hospitals lost its bid to recover over $3 million in Medicare reimbursements for bad debts because it didn’t show CMS abruptly changed the way it enforces its “must-bill” policy, the D.C. Circuit said Tuesday.

The policy has been in place since 2004, but Medicare contractors’ apparent failure to apply it prior to April 2008 wasn’t proof the Centers for Medicare and Medicaid Services changed how it enforces the policy, the U.S. Court of Appeals for the D.C. Circuit said.

Under the Medicare Act, the federal program will pay for bad debts incurred by dual-eligibles—people ...

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