CHA News Article

OIG Finds Hospital Overpayments for Transfer to Home Health Services
For directors of reimbursement, HIM professionals

The federal Department of Health and Human Services Office of Inspector General (OIG) has issued a report that concludes that Medicare overpaid acute care hospitals $267 million over a two-year period, due to improper coding of the inpatient claim when the beneficiaries resumed home health (HH) services within three days of discharge.  

The OIG notes that hospitals failed to code the inpatient claim as a discharge to home health services, or incorrectly applied condition code 42 (HH not related to inpatient stay), or 43 (HH not within three days of discharge). Based on these findings, the OIG recommends that the Centers for Medicare & Medicaid Services (CMS) direct its contractors to take steps to recover overpayments, correct related system edits, improve provider education,  and use data analytics to identify hospitals using certain conditions does disproportionately.  

The OIG also recommends that CMS take steps to deem HH services that start within three days of discharge to be related to the inpatient claim, to reduce the need for clinical judgement when processing claims.   

Click here for a summary of the report.  

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Regulations

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Quality & Patient Safety

CHA News Article

CDPH Making Calls, Conducting Visits to Support Hospitals
For licensing & certification staff, quality and patient safety staff

The California Department of Public Health (CDPH) is calling and conducting visits to hospitals that it has identified through a new hospital dashboard it is using internally. CDPH is reiterating that this dashboard focuses on hospitals currently experiencing surges and most likely to experience them. 

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Demo Shows How Hospital Quality Improvement Platform Can Identify Challenge Areas and Trends
For quality and patient safety staff

Join us on Aug. 20 from 1 to 1:30 p.m. (PT) to see a demo of the Hospital Quality Improvement Platform, HQI’s most dynamic analytical resource yet. The platform shows how your hospital compares to others and can identify challenge areas and trends to improve performance in critical areas. It gives you: 

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Medicare

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See Preview of CMS’ Care Compare Website During Upcoming Webinar
For quality and patient safety staff

The Centers for Medicare & Medicaid Services (CMS) will host a webinar on Aug. 24 at 11 a.m. (PT) to preview Care Compare, the updated website for quality information that will standardize and combine eight existing Compare sites.  

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