Beginning October 1, 2012, hospitals that have a high percentage of patient readmissions within 30 days of discharge in three specific measures (acute myocardial infarction, heart failure and pneumonia) are subject to payment reductions. See "CMS Releases Final FFY 2013 IPPS Rule." Many hospitals are therefore exploring ways to ensure that patients comply with hospital postdischarge care plans and receive good care, in an attempt to ward off readmissions.
One potential way to do this would be to make sure that patients receive any
required post-acute care services only from high-quality providers. Unfortunately from the perspective of readmission penalties, the Hospital Conditions of Participation (CoPs) place clear restrictions on the hospital’s ability to steer patients to providers of post-acute care services that the hospital believes provide a high quality of care.
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Administrative Law Updates, Health Law Updates, Insurance Updates
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