tci Medicare Compliance & Reimbursement - 2007 Issue 5

IRFs: Heads Up--OIG Is Scrutinizing Your Transfer, Discharge Billings

UGS wastes no time correcting patient status codes.United Government Services (UGS) is promptly responding to an HHS Office of Inspector General (OIG) audit released last November. The audit (A-04-04-00013) reviewed inpatient rehabilitation facilities' (IRFs') compliance with Medicare's transfer policy in 2003. How it works: Medicare pays the full prospective payment to an IRF that discharges a patient to home, but Medicare pays a lesser amount for a transfer case, according to the OIG report. A transfer is when the beneficiary's IRF stay is shorter than average, and the beneficiary transfers to another IRF, a long-term care hospital, an...

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