tci Medicare Compliance & Reimbursement - 2003 Issue 23

Reimbursement : DSH PITFALLS EMERGE IN OIG SCRUTINY

If you've had your disproportionate share hospital payment calculations challenged for including physician practice plan costs incurred by a related organization, you're not alone. Such costs were among the problems cited in a half-dozen recent DSH reviews released over the last few weeks by the HHS Office of Inspector General. Besides problems with physician practice plan costs, the OIG's findings reveal the following trouble spots in DSH accounting: inappropriately including dual eligible beneficiaries in tallies of Medicaid-eligible days; duplicating entries in computations of dual eligible days; including costs for insured patients in their uncompensated care cost figures; including costs...

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