tci Medicare Compliance & Reimbursement - 2005 Issue 23

ACUTE CARE HOSPITALS: Care-Transfer Payouts May Need Re-Transferring

Why the OIG wants CMS to collect millions in potential overpayments.Warning: Inaccurate discharge status codes could cost acute care hospitals a bundle.The Department of Health and Human Services Office of Inspector General conducted a nationwide review of acute care hospitals' compliance with Medicare's postacute care transfer policy during fiscal years 2001 and 2002, according to a recent report. The OIG sampled 400 claims in its audit, 381 of which were improperly coded as patient discharges to homes instead of transfers to postacute care facilities. Medicare pays the full diagnosis-related group payment for a discharge, but only pays...

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