As strongly advocated by the AHA, the Centers for Medicare & Medicaid Services today announced that it is rescinding prior audit denials for hospitals that had failed to qualify for the “mid-build exception” so that it can review the determinations. CMS indicates that it is taking this action out of an “abundance of caution” in response to questions raised by providers regarding the audits. The AHA has repeatedly urged the agency to rescind these faulty audit denials and to establish an informal review process to correct the errors in the determinations.
Specifically, consistent with the AHA’s recommendations, CMS states that it will review each hospital’s previously failing audit findings for compliance with statutory requirements and for accuracy and completeness. These reviews will use a broadened interpretation of what constitutes a valid construction contract required to qualify for the mid-build exception.
Hospitals that received failing audit determinations are no longer required to report or return overpayments by Sept.16 based on those determinations..