Hackensack (N.J.) UMC received more than $1.7 million in overpayments from Medicare from April 1, 2011 to Sept. 30, 2012, according to a recent OIG audit report.
The OIG's $1.7 million-estimation was based on the results of a sample of 200 reviewed claims. Of the 200 inpatient and outpatient Hackensack claims, 62 of the claims did not fully comply with Medicare's billing requirements, resulting in $352,000 in overpayments.
The OIG recommended Hackensack refund the $1.7 million to the Medicare contractor and strengthen controls in place to ensure full billing requirement compliance.
Although the medical center generally concurred with the audit findings, they did disagree with determinations for four of the 62 sampled items. Hackensack also disagreed with the OIG's statement that the hospital did not have a case worker onsite to oversee final patient discharge procedures. Hackensack also argued the error rate of the sample of inpatient short stay claims reviewed were not representative of the hospital’s overall compliance for those types of stays.
The OIG reviewed Hackensack's claims and maintained their findings with the exception of specifying that the lack of case management for overseeing final patient discharge procedures was specific to the hospital’s operating room and post-anesthesia care unit and revising their report accordingly.