Mercy Medical Center in Des Moines, Iowa, is the second hospital this week to be found with erroneous bills for Medicare coverage of a rare malnutrition condition.
According to a report from the HHS Office of Inspector General, the 656-bed Mercy Medical Center billed Medicare for kwashiorkor, a form of severe protein malnutrition that mostly affects children in famine-stricken areas and developing countries. Kwashiorkor is not common in the U.S., but Medicare still provides reimbursement for its treatment.
The OIG said 14 inpatient claims used the code for kwashiorkor when a different malnutrition code should have been used. This resulted in overpayments of $88,996. Hospital officials attributed the errors to the coding software program.
Mercy Medical Center, which underwent a separate OIG audit late last year, has taken action to refund the amount to the government. Officials also said the hospital has strengthened Medicare billing of the condition.
For calendar years 2010 and 2011, Medicare paid $711 million to hospitals for kwashiorkor claims, a high amount that has prompted the OIG to investigate the issue. The OIG recently said Christus Saint Vincent Regional Medical Center in Santa Fe, N.M., received $147,262 in Medicare overpayments stemming from kwashiorkor billing errors.
The most infamous use of kwashiorkor billing came from hospitals within Prime Healthcare Services, based in Ontario, Calif. California Watch, an investigative news outlet, reported a few years ago that Prime's Shasta Regional Medical Center in Redding, Calif., billed Medicare for more than 1,100 cases of kwashiorkor after Prime took it over in 2008. Prime has defended its billing practices but has since curbed its billing of the condition.
More Articles on Hospitals and Billing:
OIG: Christus Saint Vincent Regional Incorrectly Billed Medicare for Kwashiorkor
OIG: Medical University of South Carolina to Refund $264k
OIG Finds Medicare Billing Errors at Morton, UCH Memorial Hospitals