CommercialReimbursementHigh impact
Hospital Readmission Policy Updated effective 11/1/24
Blue Cross Blue Shield of Rhode Island·RI · Emergency Medicine, Critical Care·Facility
Effective date
Nov 1, 2024
We identified it
Jun 19, 2026
Summary
BCBSRI has extended their hospital readmission non-payment policy from 14 days to 30 days, effective November 1, 2024. Related readmissions to the same hospital or hospital system for the same, similar, or related diagnosis within 30 days will not be reimbursed for facilities using DRG or case rate contracts.
Action Required
By November 1, 2024: Billing teams must update discharge planning workflows to account for the extended 30-day readmission window (previously 14 days). Review all readmission cases within 30 days of discharge to ensure they are coded as unrelated diagnoses when appropriate. Update billing software alerts to flag potential readmissions within 30 days for manual review before submission to BCBSRI.