Staten Island University Hospital, a 668-bed hospital in Northwell Health's network, failed to comply with Medicare billing requirements for 37 of 100 inpatient and outpatient claims reviewed by HHS' Office of Inspector General, according to an OIG report released June 28.
The billing errors resulted in the New York City hospital receiving $830,291 during the audit period of 2016 and 2017, according to the OIG. Based on the review of the 100-claim sample, the OIG estimates that Staten Island University Hospital received $11.8 million in overpayments.
The OIG provided several recommendations to the hospital, including that it should refund Medicare the reported $11.8 million, identify and return any additional overpayments, and strengthen its policies and procedures to ensure compliance with Medicare billing requirements.
In written comments to the OIG's draft report, the hospital didn't expressly indicate concurrence or nonconcurrence with the recommendations. However, it did say that it believes it has rigorous internal controls and a systematized team approach to review admissions. The hospital also stated that it fully complied with 35 of the 37 claims the OIG said had errors.
After reviewing the hospital's objections and comments, the OIG maintained its findings and recommendations.
Read the full report here.