Medicare checklists for assessing reimbursement under MS-DRGs by ProQuest


Accurate Medicare reimbursement for hospitals depends on the accuracy of the bill submitted. Although this has been the case for many years, it is even more critical after the transition to Medicare severity diagnosis-related groups (MS-DRGs). The Centers for Medicare & Medicaid Services (CMS) combines cost report data with claims data to recompute MS-DRG weights from year to year. CMS plans to revise the cost report form next year to, among other things, capture the costs and charges of implantable devices separately from other supplies that are charged to patients. CMS also describes its concerns with hospital readmissions, noting that 18% of Medicare patients are readmitted to the hospital within 30 days of discharge.

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