North Shore Medical Center, a two-hospital system in Massachusetts that is part of Boston-based Partners HealthCare, will have to refund more than $816,000 in Medicare payments to the government after an audit found several billing errors, according to a report from the HHS Office of Inspector General.
The OIG audited 316 inpatient and outpatient Medicare claims within NSMC, which includes 273-bed Salem (Mass.) Hospital and 126-bed Union Hospital in Lynn, Mass. The claims were filed in 2009 and 2010.
The agency found the hospitals did not fully comply with Medicare billing requirements for 76 percent of the reviewed claims, most of which were on the inpatient side. OIG officials said the hospitals made errors because they "did not have adequate controls to prevent the incorrect billing of Medicare claims and did not fully understand the Medicare billing requirements within the selected risk areas that contained errors."
The OIG said NSMC must refund the $816,000 in overpayments and strengthen its Medicare billing procedures. NSMC agreed with the OIG on all recommendations.
The OIG audited 316 inpatient and outpatient Medicare claims within NSMC, which includes 273-bed Salem (Mass.) Hospital and 126-bed Union Hospital in Lynn, Mass. The claims were filed in 2009 and 2010.
The agency found the hospitals did not fully comply with Medicare billing requirements for 76 percent of the reviewed claims, most of which were on the inpatient side. OIG officials said the hospitals made errors because they "did not have adequate controls to prevent the incorrect billing of Medicare claims and did not fully understand the Medicare billing requirements within the selected risk areas that contained errors."
The OIG said NSMC must refund the $816,000 in overpayments and strengthen its Medicare billing procedures. NSMC agreed with the OIG on all recommendations.
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