tci Medicare Compliance & Reimbursement - 2005 Issue 40

ENFORCEMENT WATCH: Aggressive Audits Often Follow Split Claims

Why it's a good idea to keep a sharp eye on Fls.Bad news for rehab providers that don't keep tight controls on their split-claims filing. If a Medicare patient's stay in an inpatient rehabilitation facility overlaps the cost-reporting periods before and after Jan. 1, 2002, and the IRF splits the bill, Medicare may ask it to refund payments.Why: When the Centers for Medicare and Medicaid Services implemented the prospective payment system for IRFs on Jan. 1, 2002, the agency told IRFs to submit a single discharge bill for an entire inpatient stay that overlapped this date, the...

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