Queens Medical Center, an acute-care hospital located in Honolulu, did not fully comply with billing requirements for 49 of 223 claims selected for review by HHS' Office of the Inspector General, which resulted in overpayments of $318,587.
The audit covered $3.44 million in Medicare payments to the hospital for 223 claims the OIG selected as potentially at risk for billing errors. The claims had service dates of Jan. 1, 2010, through Sept. 30, 2012.
Based on the audit findings, the OIG recommended Queens Medical Center refund the $318,587 to the Medicare contractor and strengthen its controls to ensure the hospital is fully compliant with Medicare billing requirements.
The hospital concurred with all of the audit findings except the finding that inpatient claims should have been billed as outpatient or outpatient with observation services. However, Queens Medical Center has agreed to refund the entire overpayment and strengthen its internal controls.
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