Employment Law Report

As we previously reported, the Centers for Medicare & Medicaid Services (CMS) recently published new guidance requiring hospitals to document a positive COVID-19 laboratory test to receive a 20% increase in the Medicare Severity-Diagnosis Related Group (MS-DRG) weighting factor for their inpatients being treated for COVID-19. The Department of Health and Human Services Office of Inspector General (HHS OIG) has now updated its work plan providing that it will audit Medicare payments for inpatient discharges billed by hospitals for COVID-19 patients for compliance with Federal requirements, including the positive COVID-19 laboratory test requirement. Hospitals should maintain comprehensive clinical and financial documentation to support their actions and billing practices and avoid potential recoupments from audits in the future.