News Briefs: August 19, 2019

The Medicare DRG window policy was just added to the HHS Office of Inspector General’s Work Plan. “The diagnosis-related group (DRG) window policy defines when CMS considers outpatient services to be an extension of inpatient admissions, and generally includes services that are (1) provided within the 3 days immediately preceding an inpatient admission to an acute-care hospital, (2) diagnostic services or admission-related nondiagnostic services, and (3) provided by the admitting hospital or by an entity wholly owned or operated by the admitting hospital,” OIG said. “Building on previous OIG work, we will determine the number of admission-related outpatient services that were not covered by the DRG window policy in 2018…” Other new items on the Work Plan include facet joint procedures and the use of telehealth to provide behavioral health services in Medicaid managed care. Visit https://go.usa.gov/xVavW.

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