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New diagnosis-related group (DRG) readmission policy

06/19/2017

We are updating our diagnosis-related group (DRG) policy so it follows the guidelines set by the Centers for Medicare & Medicaid Services (CMS). The policy defines the payment guidelines for readmissions to an acute general short-term hospital occurring within 14 calendar days of the date of discharge from the same hospital for the same, similar or related diagnosis. This policy will go into effect July 1 for ConnectiCare Medicare Advantage and commercial plans.