Medicare wants $1.6M back from NY hospital

Massena (N.Y.) Memorial Hospital owes $1.6 million to Medicare after the federal program overpaid the hospital from 2010 through 2014, reports The Journal.

The hospital's CEO, Robert G. Wolleben, said MMH is preparing next year's budget, and is budgeting for a 2 percent profit margin, similar to what the hospital expects to end up with this year, reports The Journal. But he noted the Medicare news poses a challenge.

"Medicare has sent us a notice and they are implementing a clawback in payments they made to us in the years 2010, 11, 12, 13 and 14. They had given us in that period of time several million dollars based on a formula Medicare had set up. The clawback is $1.6 million," Mr. Wolleben said in the article. "The letter says we recalculated payments we've already made to you. You owe us $1.6 million. Pay it by 10 days. Otherwise we will charge you 9.635 percent interest. This is the kind of thing that happens all the time, so making a budget with a 2 percent operating margin is a challenge."

The CEO said MMH plans to pay what it owes via three installments, according to the report. And he noted the hospital has filed an appeal, although it was told it could not file an appeal in this case.

"Just as a matter of course to protect our interests in case somebody was incorrectly directing us, we filed an appeal. We are working with HANYS, the Hospital Association of New York. There are 14 other hospitals in the state of New York and several in the state of Maine that are affected. We're working with [U.S.] Sen. [Chuck] Schumer's office through HANYS. It's too early to say whether there will be a revision of that number," Mr. Wolleben said in the report.

 

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