Eli's Rehab Report

Published on Mon Jun 18, 2007 PDF

Washington, D.C. -- If you're a Medicare inpatient rehabilitation facility, you may want to take another look at the patients you're admitting. The HHS Office of Inspector General (OIG) released on May 1 two reports (of Whitier Rehabilitation Hospital and Catholic Medical Center for calendar year 2003) that reviewed whether the hospitals submitted IRF claims that met Medicare requirements -- and both fell short by a long shot.

Reason: "An IRF was not the appropriate setting" for nearly 50 percent of the beneficiaries in a claim sampling from both hospitals.

Needless to say, the OIG recommended that both facilities refund Medicare the resulting overpayments, which add up to the millions. Whittier is looking at a $4.8 million figure, and Catholic is looking at about $1.7 million. The OIG also recommended that both facilities strengthen their preadmission screening procedures.