Hospitals, including acute care hospitals paid under the inpatient prospective payment system, inpatient rehabilitation facilities, and long-term care hospitals, must begin to submit “no pay” claims to their Medicare contractor for Medicare Advantage (MA) beneficiaries as of Jan. 7, 2008. This will allow for the days of those stays to be eventually captured in disproportionate share hospital calculations.
In the past, MA plans were responsible for submitting this information to Medicare as part of their encounter data. However, because MA plans are no longer required to submit encounter data, hospitals must begin to submit this information.
Hospitals may submit claims with discharge dates on or after Oct. 1, 2006, so that supplemental security income (SSI) data for FY07 and beyond will include MA patient days. To ensure that hospitals’ MA days are included in the FY07 Medicare/SSI file (due in summer 2008), hospitals should try to submit their FY07 claims to their Medicare contractor from Jan. 7, 2008, through March 2008. Read the announcement.
