CHI St. Vincent in Little Rock, Ark., incorrectly billed Medicare for outlier payments that are intended to protect hospitals from large losses incurred by exceptionally expensive patient care, according to a report from HHS' Office of Inspector General.
OIG chose to audit CHI St. Vincent because the hospital's outlier payments grew nearly 547 percent from $216,484 in 2013 to $1.4 million in 2014.
An audit of 120 sampled claims from CHI St. Vincent revealed the hospital improperly billed 103 samples, resulting in $581,136 in outlier payments. Those outlier payments contained 173 billing errors. OIG said the billing errors largely occurred because CHI St. Vincent didn't properly prevent errors related to overcharged time, charge errors and coding errors.
OIG recommended that CHI St. Vincent amend the incorrect claims and return any improper outlier payments. CHI St. Vincent said it will more closely monitor billing compliance and has updated its policies and procedures.
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