tci Medicare Compliance & Reimbursement - 2003 Issue 42

Long-Term Care: THREE-DAY HOSPITAL-STAY RULE STILL VEXES OIG

Nursing homes could face overpayment demands.  Are skilled nursing facilities across the country inappropriately collecting Medicare reimbursement for patients who haven't had a three-consecutive-day hospital stay within 30 days of admission? The HHS Office of Inspector General thinks so, and has undertaken a series of reports examining the issue at Medicare contractors across the country. In the latest pair of reports - "Ineligible Medicare Payments to Skilled Nursing Facilities Under the Administrative Responsibility of TriSpan Health Services" (A-05-03-00050) and "Ineligible Medicare Payments to Skilled Nursing Facilities Under the Administrative Responsibility of Blue Cross and Blue Shield of Arizona...

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