Gain an understanding of the post-acute care transfer policy in order to maintain compliance.
As the inescapable expansion in oversight and investigation of health care claims continues, the Post-Acute Care Transfer Policy introduces obscure risks for providers that could result in Medicare program recoupments if not monitored. The HHS Office of Inspector General (OIG) has issued a series of reports which highlight what it believes to be improper payments to acute care hospitals for claims subject to the Post-Acute Care Transfer Policy. This topic helps clarify the Post-Acute Care Transfer Policy to facilitate hospitals' proactive identification of potential issues and avoid surprising retrospective paybacks. Specifically, it will address approaches to monitoring and auditing intended to identify potential issues as well as address their root causes. This information is critical for hospitals to eliminate a potential blind spot in their compliance strategy.
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Why Lorman?
Over 37 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
Agenda
Policy Basics and the Role of Discharge Codes
- Identifying the Cases to Which the Policy Applies
- Understanding How the Policy Works
- Discussion of Recent Developments
Understanding the Risk Areas and Their Drivers
- Claims Indicating a Discharge to Home
- Condition Codes Usage
- What About Common Working File Edits?
Approaches for Proactively Addressing the Risks
- Monitoring Approaches Utilizing Internal Data Sources
- Audit Considerations
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Why Lorman?
Over 37 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
Credits
OnDemand Course
This course was last revised on April 30, 2020.
Call 1-866-352-9540 for further credit information.
- CA MCLE 1.5
- Lorman Business Center, LLC. is a State Bar of California approved MCLE sponsor and this course qualifies for 1.5 CLE hours of participatory credit.
To earn each credit Lorman offers through the OnDemand learning platform, you need to watch 100% of the program. Also, for certain credits you will need to fulfill additional requirements which will be displayed on the "credits" tab when viewing the course.
This program does NOT qualify, nor meet the National Standard for NASBA accreditation.
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Why Lorman?
Over 37 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
Faculty
Peter Dressel
FTI Consulting, Inc.
- Senior managing director at FTI Consulting, Inc. and is based in Washington, D.C.
- Is in the health solutions practice in the forensic and litigation consulting segment and has been assisting legal counsel to conduct special investigations and defend clients within the health care and life sciences industries since 2001
- Has been responsible for identifying, obtaining, and using relevant data sets to build highly detailed models for evaluating health care billing issues; leading the design of complex data models; designing statistical samples and extrapolations; and analyzing various client and CMS-provided financial and accounting structured data
- His clients have included hospital systems, inpatient rehabilitation facilities, skilled nursing facilities, home health companies, hospice companies, durable medical equipment suppliers, pharmaceutical companies, device manufacturers, dialysis providers, behavioral health providers, autism services providers, and others
- Can be contacted at 202-589-2328 or [email protected]
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Why Lorman?
Over 37 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
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