CMS: Late Quality Data Submission Leads to Inflation of Reimbursement Penalty

July 24, 2014 | Health System Risk Management


​The U.S. District Court of Appeals for the Ninth Circuit upheld a 2% reduction of the market basket update penalty that an acute care hospital incurred because it was approximately 12.5 hours late submitting quality data to the Centers for Medicare and Medicaid Services (CMS) Reporting Hospital Quality Data for Annual Payment Update program.

The hospital and the vendor handling the data submission both acknowledged that the failure to meet the deadline was the fault of the vendor; in addition, the hospital argued that it had been diligent and the submission was not "very late" when advocating for a reversal of the penalty. CMS rejected the arguments, and its Departmental Appeals Board...

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