38 Hospitals the OIG Tagged for Medicare Overpayments in 2013

Here are 38 hospitals that have undergone compliance reviews from the HHS Office of Inspector General in 2013. In each of the OIG's audits, the hospital was found to have incorrectly billed Medicare, mostly due to errors with inpatient claims that should have been billed as outpatient or observation.

Note: The following information is based on the OIG's hospital-specific Medicare compliance reviews from Jan. 1 through Dec. 27, published on its website, and does not include other self-reported audits. The list only includes acute-care hospitals based in the United States. The list starts with hospitals most recently reviewed by the OIG.

1. St. Vincent's HealthCare (Jacksonville, Fla.). The OIG said St. Vincent's HealthCare received approximately $3.3 million in estimated Medicare overpayments.

2. St. Elizabeth's Medical Center (Brighton, Mass.). St. Elizabeth's, a 252-bed hospital within Boston-based Steward Health Care System, will have to repay more than $1.2 million in Medicare payments.

3. JFK Medical Center (Atlantis, Fla.). The OIG said JFK Medical Center, a 460-bed teaching hospital and part of Nashville, Tenn.-based Hospital Corporation of America, incorrectly billed Medicare by almost $4.4 million in 2009 and 2010.

4. Mercy Medical Center (Mason City, Iowa). Mercy Mason City, a 245-bed hospital within Mercy Health Network, overbilled Medicare by $223,627.

5. Mercy Medical Center (Des Moines, Iowa). Mercy Des Moines, an 802-bed hospital within Mercy Health Network, overbilled Medicare by $573,331.

6. Parkland Hospital (Dallas). The OIG found Parkland improperly received $743,582 in Medicare payments due to erroneously billed hospital outpatient dental services.

7. University Hospital (Salt Lake City). The 535-bed flagship facility of University of Utah Health Care will have to repay $256,259 to the government after a compliance review found 78 Medicare claims were incorrectly billed.

8. Mary Washington Hospital (Fredericksburg, Va.). Mary Washington Hospital, a 437-bed hospital, erroneously billed the government $327,180 in Medicare funds between 2009 and 2011.

9. MedStar Washington Hospital Center (Washington, D.C.). The 926-bed MedStar Washington Hospital Center will have to repay more than $1.06 million in Medicare reimbursements to the government.

10. UPMC (Pittsburgh). The flagship hospital campuses of UPMC — UPMC Presbyterian and UPMC Shadyside — were found to have overbilled Medicare $796,202.

11. University of Wisconsin Hospital and Clinics (Madison). The 566-bed academic medical center processed errors on inpatient and outpatient services, resulting in $316,172 in Medicare overpayments.

12. University of Miami Hospital. University of Miami Hospital, the 560-bed flagship of the University of Miami Health System, will have to repay more than $3.7 million after a compliance review found the hospital incorrectly billed Medicare on multiple inpatient claims.

13. Sanford Medical Center (Fargo, N.D.). The 583-bed hospital refunded $64,526 to Medicare due to erroneous inpatient and outpatient claims.

14. Tulane Medical Center (New Orleans). The OIG said Tulane Medical Center, a 354-bed hospital owned by HCA, should repay $523,928.

15. St. Joseph Regional Health Center (Bryan, Texas). The 310-bed St. Joseph Regional will repay the government $638,960.

16. Southcoast Hospitals Group (New Bedford, Mass.). The three-hospital Southcoast will have to refund more than $1.1 million in Medicare reimbursements.

17. Hospital of the University of Pennsylvania (Philadelphia). The 784-bed HUP, which is one of the primary teaching hospitals within the University of Pennsylvania Health System, received almost $538,000 in Medicare overpayments due to incorrectly billed inpatient and outpatient claims.

18. Community Medical Center (Missoula, Mont.). The 146-bed Community Medical Center paid back the federal government almost $158,000 due to erroneous billing of Lupron injections.

19. University of Kansas Hospital (Kansas City, Kan.). The 606-bed University of Kansas Hospital reportedly had several claims, most of which were on the inpatient side, that did not follow Medicare's billing protocol. It will have to repay $254,411.

20. Via Christi Hospital (Wichita, Kan.). Via Christi Hospital's two primary campuses, which include 759 beds, erroneously billed Medicare $170,440.

21. Wing Memorial Hospital (Palmer, Mass.). A misunderstanding of Medicare requirements and a lack of education led 74-bed Wing Memorial to overbill the government $101,138 for outpatient evaluation and management services.

22. Meritus Medical Center (Hagerstown, Md.). After a longstanding review with HHS, the 306-bed Meritus Medical Center refunded $568,420 to the government for Medicare overpayments for certain physician services.

23. Baptist Medical Center South (Montgomery, Ala.). An audit found the 454-bed Baptist had several errors in inpatient and outpatient claims during 2009 and 2010, resulting in $1.78 million in Medicare overpayments.

24. Tufts Medical Center (Boston). The OIG said Tufts must repay the federal government $1.09 million after the 415-bed hospital incorrectly billed Medicare on inpatient short stays and same-day discharges in 2009 and 2010. Tufts officials plan to appeal the audit.

25. Boston Medical Center. A compliance review found the 508-bed Boston Medical Center received $612,063 in overpayments from Medicare.

26. Community Regional Medical Center (Fresno, Calif.). The OIG said 625-bed Community Regional Medical Center must refund $1.08 million for erroneous inpatient and outpatient Medicare claims for services provided during 2008 through 2011.

27. The Brooklyn (N.Y.) Hospital Center. The 464-bed Brooklyn Hospital Center received $544,783 in Medicare overpayments during 2010 and 2011, mostly due to incorrectly billing inpatient claims.

28. Rapid City (S.D.) Regional Hospital. An audit of the 368-bed Rapid City Regional found $256,789 in overbilled Medicare funds.

29. Saint Thomas Hospital (Nashville, Tenn.). The OIG said 541-bed Saint Thomas overbilled the government by $1.09 million during 2009 and 2010 for inpatient services that should have been billed as outpatient or observation, and Saint Thomas officials argued the hospital should keep the difference between payments.

30. Cedars-Sinai Medical Center (Los Angeles). OIG officials said Cedars-Sinai overbilled Medicare more than $2.24 million over a three-and-a-half-year stretch, with most overpayments resulting from inpatient billing errors.

31. Somerset (Pa.) Hospital. The 150-bed Somerset Hospital will have to refund $313,443 to the government after an audit found outpatient and inpatient billing errors.

32. Lahey Hospital & Medical Center (Burlington, Mass.). Lahey, a 317-bed teaching hospital, was found to have inadvertently overbilled Medicare by $736,220, though Lahey officials argued the validity of the OIG's audit on inpatient short stays.

33. Sanford USD Medical Center (Sioux Falls, S.D.). In 2010 and 2011, the OIG said the 545-bed Sanford USD Medical Center received $12,222 in Medicare overpayments due to five incorrectly billed claims.

34. North Shore Medical Center (Salem, Mass.). North Shore, a two-hospital system part of Boston-based Partners HealthCare, repaid $816,000 in Medicare payments after an audit found several errors in the organization's Medicare billing processes.

35. Saint Michael's Medical Center (Newark, N.J.). Saint Michael's, a 357-bed hospital, was urged to give back $492,046 in Medicare payments after the OIG said the hospital had several errors in its inpatient and outpatient claims.

36. Norwalk (Conn.) Hospital. The OIG found the 328-bed Norwalk Hospital improperly received roughly $2.74 million in Medicare payments due to errors in inpatient rehabilitation facility claims.

37. Baton Rouge (La.) General Medical Center. Incorrect inpatient and outpatient claims led to $372,913 in Medicare overpayments at the 544-bed Baton Rouge General, which the OIG said occurred during 2009 and 2010.

38. California Pacific Medical Center (San Francisco). OIG officials said the Pacific campus of the 785-bed academic medical center complied with Medicare billing requirements for only 63 of 224 inpatient and outpatient claims, which resulted in $1.22 million in overpayments.

More Articles on Hospitals and Audits:
Maryland to Repay $115M in Miscalculated Medicaid Funds
3 Key Medicare RAC Issues for Hospitals
12 Statistics on Improper Medicare and Medicaid Payments in 2013

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