Skilled nursing facilities across the country could soon be asked to hand back Medicare dollars they've already been paid.
In a quartet of recent audit reports, the HHS Office of Inspector General notes that Medicare contractors United Government Services, Admin-aStar, CareFirst of Maryland and Palmetto GBA overpaid SNFs for residents who weren't eligible for payment. In particular, the contractors paid SNFs without verifying that residents had a qualifying three-day hospital stay preceding the SNF admission.
Some contractors point out that verifying the 3-day stay is difficult, if not impossible - a fact that is only likely to draw down...
To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.
Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.
Current newsletters added each month
Fully searchable archives - over 4200 articles
ALL years/issues back to 2003 organized by year and issue
Codes mentioned in articles are linked to Code Information pages
Code Information pages link back to related articles
Access to this feature is available in the following products: