He advises hospitals to audit every DRG 14 that was discharged to home within three days of their admission. To be in the clear of this initiative, CCOs need to ensure that they have a solid process for discharge and transfer tracking. Here s one of those new twists you were warned about. In this initiative, the OIG isn t just on the look out for hospitals that unbundled services, the agency warns that it s going to return to those hospitals that have already settled on the issue possibly hundreds of hospitals to ensure that they are complying with settlement agreements. And my experience sadly has been that most hospitals that entered into those agreements paid no attention to those compliance obligations, and they are now in violation of those agreements.
Haik advises CCOs to review their stat orders to make sure that they re documented correctly.
This initiative could prove valuable for many health care organizations that have struggled with implementing a compliance program. Everybody can then adjust their future practice accordingly. The agency suspects that physicians often do not have relationships with their home health patients and rely on the home health agencies to determine needed care. Spargo suggests that this initiative may be aimed at getting physicians more involved in the research involved in home care decision-making. The OIG plans to examine the process used by nursing homes to perform resent assessments, and how nursing homes develop plans of care and payment accuracy based on assessments.