According to the Miami Herald, the University of Miami Hospital will have to refund $3.7 million to Medicare after a federal audit of the hospital’s billing practices found the hospital overbilled in 2009 and 2010, according to a report released Tuesday by the U.S. Department of Health and Human Services Office of Inspector General.
The HHS OIG audited $22.8 million in Medicare payments to the hospital, out of $223 million in total payments in 2009 and 2010, for 2,194 claims. It then took a random sample of 200 claims for $2.9 million. Of that, it found billing errors in 68 claims for $524,009.
These are the billing errors that HHS OIG found at UM Hospital:
- Patients were incorrectly billed as inpatients when they should have been outpatients, resulting in $447,982 in overpayments. This one of the most common areas regulators are scrutinizing.
- Patients were billed as discharges and readmissions within the same day, resulting in $33,645 in improper charges.
- Using an incorrect diagnosis or treatment code, resulting in $17,475 in overpayments.
- Patients were incorrectly billed as discharges when they were transferred to another hospital the same day, resulting in $16,407 in improper payments.
- The hospital failed to obtain a manufacturer's warranty on a medical device, costing $8,500.
Hospital officials disagreed with several portions of the OIG's review. They said some of the inpatient claims were not improperly billed, and officials also did not agree with the OIG's decision to extrapolate the results. In addition, University of Miami Hospital executives said they should be able to rebill Medicare Part B for some of the services that should have been billed as outpatient.
Emily Sutherlin is also the Pregnancy Examiner.
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