New York-based Beth Israel Medical Center has agreed to pay the U.S. government $13 million after it admitted it practiced "turbocharging" in the late 1990s and early 2000s to receive higher Medicare payments, according to a New York Times report.
Turbocharging is when a hospital or provider fraudulently increases billed charges for providing care that are far higher than the actual costs associated with that care. In this case, Beth Israel turbocharged to obtain excessive outlier payments for Medicare inpatients. CMS pays outlier payments to providers for treating inpatients whose care involves extraordinarily high costs compared with the normal inpatient.
According to the complaint, Beth Israel began increasing its charges in the late 1990s. In 1996, CMS paid the hospital $5.2 million in outlier payments, and that figured increased to $8.1 million in 1997.
Beth Israel, which is part of Continuum Health Partners, hired the National Revenue Group in 1999 to recommend strategic charge increases that would lead to even greater outlier payments, according to the report. In fiscal year 1997, CMS raised the outlier payment threshold to $9,700 per inpatient discharge, and the threshold was raised to $33,560 in 2003.
In total, from 1996 to 2003, Beth Israel's Medicare inpatient costs increased by $17.4 million, while its Medicare inpatient charges increased by more than $285 million. Due to the statutes of limitation, the settlement only covers excessive Medicare outlier payments from Feb. 21, 2002, through Aug. 7, 2003, when Beth Israel stopped its turbocharging practices.
Turbocharging is when a hospital or provider fraudulently increases billed charges for providing care that are far higher than the actual costs associated with that care. In this case, Beth Israel turbocharged to obtain excessive outlier payments for Medicare inpatients. CMS pays outlier payments to providers for treating inpatients whose care involves extraordinarily high costs compared with the normal inpatient.
According to the complaint, Beth Israel began increasing its charges in the late 1990s. In 1996, CMS paid the hospital $5.2 million in outlier payments, and that figured increased to $8.1 million in 1997.
Beth Israel, which is part of Continuum Health Partners, hired the National Revenue Group in 1999 to recommend strategic charge increases that would lead to even greater outlier payments, according to the report. In fiscal year 1997, CMS raised the outlier payment threshold to $9,700 per inpatient discharge, and the threshold was raised to $33,560 in 2003.
In total, from 1996 to 2003, Beth Israel's Medicare inpatient costs increased by $17.4 million, while its Medicare inpatient charges increased by more than $285 million. Due to the statutes of limitation, the settlement only covers excessive Medicare outlier payments from Feb. 21, 2002, through Aug. 7, 2003, when Beth Israel stopped its turbocharging practices.
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