Industry News

March 27, 2012 12:48:58 pm

OIG Reviews Several Hospitals for Medicare Billing Issues

After recent reviews of Medicare payments at several hospitals, the Office of the Inspector General (OIG) has found over $1.8 million in overpayments.  Most of the payments were the result of billing errors.

The OIG reviewed selected claims at four hospitals in the last month.  Most of the errors fell into one of these categories:

  • Lack of controls to prevent incorrect billing
  • Lack of understanding of Medicare billing requirements
  • Inadequate training
  • Keying errors by new coding staff

Brigham and Women’s Hospital
in Boston had the largest number of errors, with over one-third of the reviewed claims resulting in overpayments.  OIG has asked the hospital to reimburse Medicare $1.5 million for the 219 claims that were improperly paid and to implement controls to ensure full compliance with Medicare requirements.

According to the Centers for Medicare & Medicaid Services (CMS), Recover Audit Contractors have identified approximately $1.27 billion in Medicare overpayments since October, 2009.

For a detailed report of the OIG’s announcement, please see Healthcare Finance News.


Tags: Healthcare


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