| 1999 |
The Centers for Medicare and Medicaid Services (CMS) initiated a reimbursement methodology related to certain Diagnostic Related Groups (DRGs) involving transfers to post-acute care facilities (e.g., SNF or rehab facility) or to home health care. Initially, 10 DRGs were involved. |
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| October 2003 |
29 DRGs are subject to overpayments |
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| October 2005 |
182 DRGs are subject to overpayments |
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| October 2006 |
188 DRGs are subject to overpayments |
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| October 2007 |
273 DRGs are subject to overpayments |
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In an effort to address these inpatient overpayment issues, “Transfer DRGs” (TDRGs) were established, with corresponding edits, checks and balances incorporated into the CMS payment systems. |
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| 2008 |
OIG stated in their 2008 Work Plan that they would be reviewing patient discharges that should have been coded as transfers rather than discharges. As a result, compliance issues with Transfer DRG regulations are becoming even more prevalent and important for providers and the potential negative impact on a hospital’s reimbursement for Transfer DRGs continues to grow. |
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