4 recent hospital payment disputes

The following payment disputes occurred during the first two weeks of August.

1. 2 Mississippi hospitals filed suit over 2014 Medicaid underpayments
Gulfport, Miss.-based Memorial Hospital and Singing River Health System in Pascagoula, Miss., filed suit against the Division of Medicaid after the agency denied their appeal to recover underpayments from fiscal year 2014.

2. OIG: New York-Presbyterian received $14.2M in Medicare Overpayments
NewYork-Presbyterian Hospital failed to comply with Medicare billing requirements for 123 of 285 inpatient and outpatient claims reviewed by HHS' Office of the Inspector General during the audit period of Jan. 1, 2011, through Dec. 31, 2012. NewYork-Presbyterian disagreed with most of the OIG's findings.

3. Medical University Hospital sues BlueCross BlueShield of SC for alleged nonpayment
Charleston, S.C.-based MedicalUniversityHospital sued BlueChoice Health Plan of South Carolina, a subsidiary of Blue Cross Blue Shield South Carolina, for allegedly failing to reimburse the hospital for providing care to Medicaid patients covered by the BlueChoice managed care plans.

4. CMS denies Partners' appeal to rectify math errors
CMS said it will not allow Boston-based Partners HealthCare to resubmit paperwork for 19-bed Nantucket (Mass.) Cottage Hospital that, if it had been filed correctly, would have resulted in higher Medicare payments to Massachusetts hospitals.


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