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how did central georgia rehab hospital escape medicare billing infractions

by Loraine Nader Published 2 years ago Updated 1 year ago
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Do rehab centers in Georgia accept Medicaid plans?

Apr 28, 2015 · The Macon-based Medical Center of Central Georgia, the second largest hospital in the state, will pay $20 million to settle allegations that …

Do Georgia treatment centers accept Medicare insurance?

Apr 29, 2015 · Department of Justice announced that The Medical Center of Central Georgia, the second largest hospital in Macon, Georgia, agreed to a $20 million settlement to resolve allegations that it ...

What is the surprise billing law in Georgia?

Jul 20, 2020 · On July 16, 2020, Governor Kemp signed into law HB 888, the Surprise Billing Consumer Protection Act, to take effect starting January 1, 2021. The new law aims to stop “surprise” billing to patients who have received out-of-network care from healthcare providers and facilities. These unexpectedly high medical bills are often called “surprise” or “balance” bills and …

Where can I go for mental health treatment in Georgia?

Jun 22, 2009 · Central Georgia Rehabilitation Hospital - Unethical & Unsatisfactory Treatment. My father had been hospitalized for over a month, and then was sent to Central GA Rehabilitation Clinic for rehabilitation, especially for his legs. After THREE days, two of which were spent working on his arms, he was released with a form stating that he was able ...

Central Georgia Rehabilitation Hospital Customer Service Contacts

ComplaintsBoard.com is not affiliated, associated, authorized, endorsed by, or in any way officially connected with Central Georgia Rehabilitation Hospital Customer Service. Initial Central Georgia Rehabilitation Hospital complaints should be directed to their team directly.

Central Georgia Rehabilitation Hospital Complaints & Reviews

My father had been hospitalized for over a month, and then was sent to Central GA Rehabilitation Clinic for rehabilitation, especially for his legs. After THREE days, two of which were spent working on his arms, he was released with a form stating that he was able to function normally in a regular residential setting.

When was the CMS rule for major multiple traumas?

In the proposed rule dated September 9, 2003 (FR 68, 53272) CMS clarified which patients should be counted in the category of major multiple traumas to include patients in diagnosis-related groups 484, 485, 486 or 487 used under the IPPS.

What is Medicare certified hospital?

Section 1886(d)(1)(B) of the Social Security Act (the Act) and Part 412 of the Medicare regulations define a Medicare certified hospital that is paid under the inpatient (acute care hospital) prospective payment system (IPPS). However, the statute and regulations also provide for the classification of special types of Medicare certified hospitals that are excluded from payment under the IPPS. These special types of hospitals must meet the criteria specified at subpart B of Part 412 of the Medicare regulations. Failure to meet any of these criteria results in the termination of the special classification, and the facility reverts to an acute care inpatient hospital or unit that is paid under the IPPS in accordance with all applicable Medicare certification and State licensing requirements. In general, however, under §§ 412.23(i) and 412.25(c), changes to the classification status of an excluded hospital or unit of a hospital are made only at the beginning of a cost reporting period.

What is Medicare IRF?

All hospitals or units of a hospital that are classified under subpart B of part 412 of the Medicare regulations as inpatient rehabilitation facilities (IRFs). Medicare payments to IRFs are based on the IRF prospective payment system (PPS) under subpart P of part 412.

When was the 412.23(b)(2) review suspended?

On June 7 , 2002, CMS notified all ROs and FIs of its concerns regarding the effectiveness and consistency of the review to determine compliance with §412.23(b)(2). As a result of these concerns, CMS initiated a comprehensive assessment of the procedures used by the FIs to verify compliance with the compliance percentage threshold requirement and suspended enforcement of the compliance percentage threshold requirement for existing IRFs. The suspension of enforcement did not apply to a facility that was first seeking classification as an IRF in accordance with §412.23(b)(8) or §412.30(b)(2). In such cases, all current regulations and procedures, including §412.23(b)(2), continued to be required.

What is 412.23(b)(2)?

Under revised §412.23(b)(2), a specific compliance percentage threshold of an IRF’s total patient population must require intensive rehabilitation services for the treatment of one or more of the specified conditions. Based on the final rule, CMS issued a Joint Signature Memorandum including instructions related to Regional Office (RO) and Medicare fiscal intermediary (FI) responsibilities regarding the performance of reviews to verify compliance with §412.23(b)(2) as detailed in CRs 3334 and 3503, which revised Medicare Claims Processing Manual Chapter 3, sections 140.1 to 140.1.8. (CR 3503 corrected some errors or clarified the instructions in CR 3334 and presented additional instructions to implement revised §412.23(b)(2).

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