The Office of Inspector General has this month, released a report entitled CMS Improperly Paid Millions of Dollars for Skilled Nursing Facility Services When the Medicare 3-Day Inpatient Hospital Stay Requirement Was Not Met. Under the law, post-hospital extended care is reimbursable when there is a 3-day consecutive inpatient hospital stay.
According to the OIG, there was a lack of coordinated notification between hospitals, beneficiaries and SNF’s. The OIG recommended additional notice to beneficiaries be made by hospitals. CMS apparently disagrees.
To protect themselves, SNF’s should check internal systems for catching improper claims for reimbursement in this kind of scenario.