posted by MCG
on April 30, 2019
Whether or not a procedure is on the Medicare Inpatient-Only List (IOL) has significant ramifications for patients and providers. To properly utilize the IOL, it is vital to understand the world of outpatient surgery; for example, the definition of what constitutes an outpatient procedure can vary by payer. Whatever the definition, the proportion of procedures performed on an outpatient basis is increasing. The Medicare IOL can be a tool to help make some of these determinations, but often the purpose and implications of the list are misunderstood.
This white paper aims to explore many of the myths surrounding the Medicare Inpatient-Only List, the recent changes to the list, and address common misunderstandings.
This paper represents the views of the author, not America’s Health Insurance Plans (AHIP). The publication, distribution or posting of this paper by AHIP does not constitute a guaranty of any product or service by AHIP.