OIG Claims Georgetown University Hospital Overbilled Medicare by 659K

A report from the Office of Inspector General claims Georgetown University Hospital in Washington, D.C., overbilled Medicare by roughly $659,400 primarily due to misunderstandings of billing requirements.

The OIG has recommended the hospital refund the overpayments, which consist of 94 incorrectly billed inpatient claims for short stays and excess charges and 40 incorrectly billed outpatient claims. It also recommended Georgetown strengthen its controls to ensure full compliance with Medicare requirements.

The 609-bed hospital issued comments to the OIG, concurring that the 94 inpatient claims were billed incorrectly. The hospital disagreed with OIG's overpayment amount for the inpatient claims, however, claiming it is should be less than $634,653. The hospital said it anticipates lower figures once reimbursements are adjusted for the correct DRG assignments and Part B services provided.

The hospital has agreed to refund $24,718 for the outpatient claims billed in error, but for inpatient claims, it "will process appropriate refunds to the Medicare Administrative Contractor" pending adjustment to reimbursement made for the services provided.

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