Section 443.9. Payments for Readmission to a Hospital Paid Through Diagnosis-Related Groups.--All of the following shall apply to eligible recipients readmitted to a hospital within thirty days of the date of discharge:
(1) If the readmission is for the treatment of conditions that could or should have been treated during the previous admission, the department shall make no payment in addition to the hospital's original diagnosis-related group payment. If the combined hospital stay qualifies as an outlier, as set forth under the department's regulations, an outlier payment shall be made.
(2) If the readmission is due to complications of the original diagnosis and the result is a different diagnosis-related group with a higher payment, the department shall pay the higher diagnosis-related group payment rather than the original diagnosis-related group payment.
(3) If the readmission is due to conditions unrelated to the previous admission, the department shall consider the readmission as a new admission for payment purposes.
(443.9 amended June 30, 2011, P.L.89, No.22)