tci Medicare Compliance & Reimbursement - 2003 Issue 20

Hospitals: 19 DRGs ON PER-DIEM CHOPPING BLOCK

Hospitals have long grumbled over the Centers for Medicare & Medicaid Services' post-acute transfer policy. But if an upcoming CMS proposal gets finalized, the policy will apply to nearly three times as many diagnosis related groups. Under the transfer policy, when patients with certain conditions are discharged to a post-acute care setting, the hospital is paid a per diem rate rather than the full DRG amount. Currently, 10 DRGs are subject to the policy - but in an inpatient prospective payment system update unveiled May 9, CMS proposes to add 19 new DRGs to the existing 10. The new...

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