tci Medicare Compliance & Reimbursement - 2007 Issue 20

AUDITS: Feds Crack Down On Validity Of IRF Admissions

OIG orders millions of dollars of refunds from IRFs for Medicare overpayments.If you're a Medicare inpatient rehabilitation facility (IRF), you may want to take another look at the patients you're admitting.The HHS Office of Inspector General (OIG) released on May 1 two reports (of Whittier Rehabilitation Hospital and Catholic Medical Center for calendar year 2003) that reviewed whether the hospitals submitted IRF claims that met Medicare requirements--and both fell short by a long shot.Reason: "An IRF was not the appropriate setting" for nearly 50 percent of the beneficiaries in a claim sampling from both hospitals.Recommendation:...

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