White Paper

3 Pages
  • 3 Pages

CMS Softens Physician Inpatient Order Documentation Requirement


What are the implications for providers?

The Centers for Medicare & Medicaid Services, as of 10/1/18, eliminated the requirement that a signed physician order needs to be in the medical record to set up inpatient coverage. It may seem like this change in guidance does away with one technical basis for denials, however it doesn’t remove the need for evidence that a physician judged a patient in need of inpatient services. This white paper reviews this changed in requirements; and discusses implications for providers.



Leslie Demaree Goldsmith

Baker, Donelson, Bearman, Caldwell & Berkowitz, PC

Leslie Demaree Goldsmith is a shareholder at Baker, Donelson, Bearman, Caldwell & Berkowitz, PC. Ms. Goldsmith brings more than 25 years of experience to her practice, representing health care providers such as hospitals, home health agencies and skilled nursing facilities. She provides advice on Medicare and Medicaid reimbursement and regulatory issues involving conditions of payment and conditions of participation. Ms. Goldsmith's diverse experience includes issues involving PPS, provider-based status, wage index, bad debt, quality data, medical education (GME, IME, Nursing and Allied Health), DSH, and cost allocation, as well as billing and claims issues, the Two-Midnight rule, quality reporting, telemedicine, 340B and Medicare bundled payments.

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