Two separate reports from the HHS Office of Inspector General found two Iowa hospitals within the Mercy Health Network — Mercy Medical Center in Des Moines and Mercy Medical Center in Mason City — erroneously billed Medicare, which led to overpayments.
For Mercy in Des Moines, an 802-bed hospital, the OIG combed through 557 inpatient and outpatient claims submitted in 2009 and 2010. The agency found Mercy Des Moines did not comply with Medicare billing requirements on 91 of those sample claims, resulting in $573,331 in overpayments. Hospital officials agreed with most of the OIG's findings, but they argued against a few outpatient claims. However, the OIG stood behind its audit.
For Mercy in Mason City, a 245-bed hospital, the OIG found Medicare overpayments totaling $223,627. The audit was based on 145 inpatient and outpatient claims billed during 2010 and 2011. Mercy Mason City concurred with all of the OIG's findings.
Englewood, Colo.-based Catholic Health Initiatives and Livonia, Mich.-based Trinity Health created Mercy Health Network in 1998 under a joint operating agreement. Mercy Des Moines and Mercy Mason City are two of the five medical centers within the network.
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