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HOSPITAL PAYMENT MONITORING PROGRAM (HPMP)

Admissions with three day or less length of stay
The Hospital Payment Monitoring Program (HPMP) is a nationwide effort by the Centers for Medicare & Medicaid Services (CMS), an agency of the Department of Health and Human Services, to protect the Medicare trust fund by ensuring that Medicare pays for services that are reasonable and medically necessary.

The long-term goal of HPMP (formerly known as the Payment Error Prevention Program) is to help inpatient prospective system hospitals prevent payment errors by analyzing data, conducting focused audits, and implementing system changes to ensure payment accuracy.  NDHCRI currently provides data, education, and assistance to hospitals to meet this goal.  The purpose of HPMP is to measure, monitor, and reduce the incidence of Medicare payment errors for short-term and long-term inpatient prospective payment system hospitals.

NDHCRI is currently conducting a HPMP project to review for accuracy of claims billed inpatient for three days or less length of stay.  On this portion of the website NDHCRI will post HPMP educational materials, tools and/or links that will be helpful to providers.

Please follow these links to learn more about the individual topics:

NDHCRI Admission Criteria with instructions
Hospital Conditions of Participation
 MedLearn Matters: Use of Condition Code 44: "Inpatient Admission Changed to Outpatient"

Exhibits of the Hospital Issued Notices of Non-coverage

Portions of the NDHCRI hospital informational manual
 Medicare inpatient only procedure list
HPMP Compliance workbook
HPMP resource page

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