CMS updates information related to pause of QIO short-stay reviews

The Centers for Medicare & Medicaid Services today updated information on the temporary pause of Quality Improvement Organization Beneficiary and Family Centered Care’s claim audits under the two-midnight inpatient admissions policy. CMS said the pause in audits is still in effect, and when the audits resume they will be limited to a six-month look-back period from the date of admission. “The imposition of a six-month look-back period for claims impacted by the temporary suspension of the BFCC reviews is being implemented to help ensure that providers receiving denials for Part A claims have sufficient time to rebill under Medicare Part B,” CMS said. In addition, the agency announced that claims already audited by the QIOs that are outside the six-month timeframe will be paid under Part A.