Chicago hospital's Medicare overpayments climb to $21M

Rush, an academic health system based in Chicago, recently released its financial results for the second half of 2018 and provided an update on an ongoing claims audit.

Rush reported operating revenues of $1.28 billion in the six months ended Dec. 31, up from $1.19 billion in the same period of the year prior. The three-hospital system said its operating expenses were down 9.9 percent year over year in the second half of 2018.

After factoring in a nonoperating expense of $37.43 million, Rush's total expenses exceeded revenues by $38.94 million. That's compared to the six months ended Dec. 31, 2017, when the system's revenues exceeded expenses by $91.5 million.

In its recent financial filing, Rush disclosed additional details about an audit conducted by HHS' Office of Inspector General.

An OIG report released in 2017 found Rush University Medical Center did not comply with Medicare billing requirements for certain rehabilitation claims submitted over a two-year period. As a result, Rush's Medicare administrator contractor recouped $10.3 million from the hospital in 2018, according to the financial filing.

Rush disputed the OIG's findings and is continuing to work with the federal government to get the overpayment amount reduced.

"RUMC has and will continue to appeal the OIG's determination on these claims and the amount of the recoupment through the appropriate administrative process," the hospital stated in the earnings release. "Any repayments recouped from or made by RUMC related to this two-year audit period would be offset by any recoveries determined appropriate for RUMC at the end of the appeals process."

Rush also disclosed that it expects to repay an additional $10.8 million to resolve potential overpayments received over a four-year period. The system self-reported the information related to those claims to the federal government, a spokesperson told the Chicago Tribune.

The system is working with the OIG to determine the exact repayment amount, according to the report.  

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