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Clarifications Regarding the Medicare 3-Day DRG Rule
(posted May 2, 2012)
The Centers for Medicare and
Medicaid Services ("CMS") has provided certain changes
and clarifications to the 3-Day Rule that could
potentially have an adverse impact on the ability of a
Hospital "owned or operated" physician practice (which
may include a captive or controlled professional
corporation ("Captive PC")), to bill Medicare for
diagnostic and/or related non-diagnostic services
provided within the 3 day window prior to an inpatient
admission to the Hospital. CMS has said it will
actively enforce this rule as of July 1, 2012.
to read entire Legal Alert.