tci Medicare Compliance & Reimbursement - 2003 Issue 21

Hospitals: HOSPITALS MUST BEEF UP POST-ACUTE TRANSFER COMPLIANCE

Hospitals with high error rates for post-acute transfers could be in for aggressive enforcement actions from federal regulators. In its latest review of post-acute transfer compliance, the HHS Office of Inspector General estimates that hospitals collected more than $60 million in overpayments in 2000 based on improperly classifying transfer patients as discharges. Under the post-acute transfer policy, if a beneficiary in one of 10 specified diagnosis related groups is discharged to a post-acute provider, the discharge will be treated as a transfer for payment purposes. In essence, that means that the hospital will be paid a per diem rate...

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