Home Health & Hospice Week

Industry Notes:

OIG FOCUS ON HOSPITAL TRANSFERS COULD AFFECT YOUR REFERRALS

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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