CMS Identifies Inpatient Rehabilitation Facility (IRF) Overpayments

On June 9, 2010, the Office of Inspector General (OIG) published a report regarding inpatient rehabilitation facility (IRF) payments made in 2006 and 2007. According to this report, over half of the claims reviewed (i.e., 113 out of 200 claims) resulted in overpayments, because the providers failed to submit patient assessment instruments within the requisite time frame (27 calendar days). The OIG indicated that if the results of the study were projected, it is possible that the Centers for Medicare and Medicaid Services (“CMS”) overpaid approximately $20 million. The OIG recommended that the non-sampled claims immediately be reopened and reviewed and overpayments collected.

Please contact Abby Pendleton, Esq. or Jessica L. Gustafson, Esq. with any questions at (248) 996-8510.