Medicare Overpaid Inpatient Rehabilitation Facilities Millions of Dollars for Claims With Late Patient Assessment Instruments for Calendar Years 2009 and 2010.

摘要

Under the prospective payment system for inpatient rehabilitation facilities (IRF), the Centers for Medicare & Medicaid Services (CMS) establishes a prospective payment rate for each of 92 distinct case-mix groups. Medicare Part A Medicare Administrative Contractors (MAC), under contract with CMS, use the Fiscal Intermediary Shared System (FISS) to process and pay claims submitted by IRFs. To administer the prospective payment system, CMS requires IRFs to electronically transmit a patient assessment instrument (PAI) for each IRF stay to the National Assessment Collection Database (the Database).