tci Medicare Compliance & Reimbursement - 2004 Issue 44

Rehab: OIG Work Plan Targets Admissions, Outliers In Inpatient Rehab Facilities

Zero in on problem areas through routine checks to protect your facility.The HHS Office of Inspector General's 2005 Work Plan leaves no stone unturned as it probes inpatient rehab facilities' payment practices. But watching documentation p's and q's will put IRFs ahead of the game if auditors land on their doorstep. Admissions top the list of the OIG's IRF targets, so providers will need to show that patients meet Medicare's specific requirements for IRFs, including appropriate preadmission screening and assessment testing. Behind this admissions scrutiny is CMS' perception that many IRFs aren't complying with medical necessity...

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