December 27, 2017 / 9:20 PM / 2 months ago

Medicare criteria for recalculating hospital payments upheld on appeal

A federal appeals court has reversed a decision that invalidated U.S. Centers for Medicare and Medicaid Services criteria used to determine whether Medicare payments to hospitals for treating unusually expensive procedures should be recalculated for possible overcharges.

The U.S. Court of Appeals for the District of Columbia Circuit ruled on Tuesday that, contrary to what a lower-court judge had held, instructions contained in a 2010 CMS manual constituted a general policy statement, not a formal rule.

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