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Home Health & Hospice Week

Industry Notes:

OIG FOCUS ON HOSPITAL TRANSFERS COULD AFFECT YOUR REFERRALS

Published on Fri Feb 13, 2009

Enforcement of the payment provision that punishes hospitals for transferring patients home may tighten. If you've seen a decrease in your hospital referrals since 2004, a new report might point to the reason why. A Medicare payment system edit started enforcing the post-acute care transfer policy for hospitals on Jan. 1 of that year, points out a new report from the HHS Office of Inspector General (A-04-07-03035). Background: Under the transfer policy,hospitals' DRG payments get prorated if they discharge a patient to home care before the median length of stay. The patient must go to home care within three days of discharge to trigger the proration.The Centers for Medicare & Medicaid Services expanded the policy to a whopping 273 DRGs last year (see Eli's HCW, Vol. XVI, No. 28, p. 215). Medicare overpaid hospitals nearly $25 million for improperly identified claims that should've been subject to transfer policy proration from [...]
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