tci Medicare Compliance & Reimbursement - 2005 Issue 1

ENFORCEMENT WATCH: Feds Are Cracking Down On Transfer Coding Errors

Relatively small settlements not deterring investigations. The Department of Health and Human Services' national Prospective Payment System Hospital Transfer Project continues to net scores of hospitals for improperly coding patient transfers as discharges. The government's latest $164,000 settlement targeted Missouri-based Pike County Memorial Hospital and numerous member hospitals of SSM Health Care and Sisters of Mercy Health System, U.S. Attorney James Martin said Nov. 24."The hospitals' improper coding of patient transfers allowed them to receive full diagnostic related group payments from the Medicare program, rather than the per diem Medicare payments to which they were...

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