Mary Hitchcock Memorial Hospital in Lebanon, N.H., failed to comply with Medicare billing requirements for 225 inpatient and outpatient claims reviewed by HHS' Office of Inspector General during the audit period of 2009 through 2012, according to a recent OIG audit report.
The 225 claims that did not fully comply with Medicare billing requirements resulted in the hospital receiving $770,735 in overpayments, according to the OIG. Specifically, 33 inpatient services had billing errors, resulting in net overpayments of $462,232, and 222 outpatient services had billing errors, resulting in overpayments of $308,503.
Based on the sample results, the OIG estimated that the hospital received at least $1.39 million in overpayments from Medicare during the audit period.
Based on its findings, the OIG recommended the hospital refund the Medicare contractor $452,145 in estimated overpayments for the incorrectly billed services that are within the three-year claims recovery period, work with the contractor to return overpayments outside of the three-year recovery period in accordance to the 60-day repayment rule and strengthen its controls to ensure full compliance with Medicare compliance.
Mary Hitchcock partially disagreed with the OIG's findings and recommendations. For claims outside of the three-year recovery period, the hospital said it intends to refund amounts for the overpayment determinations with which it agrees. For the remaining claims, the hospital stated it will await the contractor's determination regarding the use of extrapolation and the recovery of identified payments outside of the three-year recovery period.
After receiving the hospital's comments and objections, the OIG maintained its findings and recommendations.
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