On September 22, 2014, CMS released the audio recording and written transcript of the MLN Connects Hospital Appeals Settlement Program call held on September 9, 2014. CMS also updated its FAQ's related to the program. Of note in the updated FAQ's, CMS confirmed that all settled claims will be paid in 1 or 2 lump sum payments by the Medicare contractor and that the provider will receive a statement from the contractor itemizing all the claims included in the payment; however, "Claims will be remain [sic] as denied in CMS systems and will not be included for cost report purposes, including the GME Medicare Part A percentage."
In addition, hospitals may not claim any uncollected deductible/co-insurance from the settled claims as Medicare Bad Debt for cost reporting purposes. CMS further clarified that the settlement amount will be 68% of the net paid/payable amount, which does not include any deductible or co-insurance amount. This amount is distinct from the "gross" or "allowable" amounts, which include the out-of-pocket obligations.
CMS will hold another teleconference on October 9, 2014 to address the updated information and answer further provider questions regarding the Hospital Appeals Settlement Program. Interested parties can register for the call here.