CHA News Article

OIG Reports Many LTCHs Not Reporting Co-Located Status
Inaccurate information may lead to Medicare overpayments

The U.S. Department of Health and Human Services Office of Inspector General (OIG) notified the Centers for Medicare & Medicaid Services last week that many long-term care hospitals (LTCHs) have not, as required by federal regulations, notified their claims processing contractors that they are co-located with another hospital-level provider or skilled-nursing facility. According to the OIG’s early alert memorandum report, the lack of information on co-located status can prevent the application of two payment polices that lower Medicare payments, including the “25-percent rule” governing admission referral sources and payment policy for interrupted stays. The OIG’s preliminary analysis revealed that nearly half of the 211 LTCHs identified as having co-located status had not reported this information to their claims processing contractors. A copy of the OIG’s report is attached.