Tony Salters, a CMS spokesman, said the names of those organizations aren't yet public. The American Hospital Association and the Federation of American Hospitals also did not provide any details.
The government's offer applies to appeals in which private recovery auditor contractors, or RACs, determine hospitals should have labeled short inpatient stays as outpatient visits. For hospitals, those determinations result in lower reimbursements, while patients are subjected to higher Medicare cost-sharing.
Several industry observers have said the offer may be too good for hospitals to pass up because a quick partial payment may outweigh the possibility of losing an appeal, which is not likely to be heard in Medicare's backlogged system anytime soon.
Although four providers is a small initial sample size, it could be significant depending on what systems are taking the deal. Emily Evans, a RAC expert who has followed the issue, said a large chunk of the short inpatient-stay RAC appeals comes from a relatively small portion of the provider community, mostly the large not-for-profit and for-profit systems that can afford to navigate the long and costly appeals process. If the big players think the deal is worth taking, others might follow suit.
“There are a number of pretty savvy providers that tend to pursue appeals,” Evans said. “But the number of hospital systems here is not enormous.”
Hospitals have until Oct. 31 to send a settlement request to the CMS.
Follow Bob Herman on Twitter: @MHbherman