Watchdog Urges Medicare To Widen Pre-Inpatient Pay Window

By Daniel Wilson (February 20, 2014, 2:15 PM EST) -- Medicare and its beneficiaries could see millions of dollars in savings if the Centers for Medicare and Medicaid Services extends the window under which outpatient services prior to an inpatient visit are considered to be included under the same lump-sum payment, according to a report released Wednesday.

Under the current so-called DRG window — named after the Medicare inpatient services lump-sum payment, known as the Medicare Severity Diagnosis Related Group payment — Medicare and beneficiaries don't pay additionally for outpatient services done within three days prior to an inpatient admission if the outpatient facility is owned or operated by the admitting...

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