Contractor's errors prompted $2.7M Medicare refund from Kansas hospital, lawsuit claims

Hutchinson (Kan.) Regional Medical Center is suing the company it contracted with to manage hospital operations, alleging the company's errors resulted in the hospital having to refund Medicare more than $2.7 million in July for overpayments, according to The Hutchinson News, which cites the lawsuit.

The hospital recently filed the lawsuit against RehabCare Group Management Services, doing business as Kindred Hospital Rehabilitation Services, alleging breach of contract and seeking compensation for money the hospital had to refund Medicare.

Louisville, Ky.-based Kindred, which first contracted with the hospital in 2011 and remains contracted, had not responded to the lawsuit as of Nov. 7, according to the newspaper.

The lawsuit allegations relate to events that occurred in 2014 or earlier. In the lawsuit, Hutchinson Regional Medical Center says the hospital "discovered [after a July 2018 review] that seven of nine claims reviewed" for all or part of fiscal years 2012, 2013 and 2014 lacked a physician signature on the care plan, lacked a proper physician order or failed to meet other Medicare requirements, The Hutchinson News reported.

Further evaluation by the hospital auditor found that 58 of 63 randomly selected claims submitted during fiscal years 2012 through 2014 were deficient, the hospital charged in the lawsuit.

Hutchinson told Becker's Hospital Review that the hospital's auditor used the results of the statistical sample and extrapolated the results to about 200 claims submitted to Medicare from 2012 to 2014. The review resulted in a net total overpayment of $2,770,004.12.

Hutchinson Regional Medical Center said the quality of patient care was never affected by the deficiencies allegedly caused by Kindred personnel.

Becker's Hospital Review reached out to Kindred and will post more information as it becomes available.


More articles on healthcare finance: 

CMS reimbursements delayed under new skilled nursing facility payment model
CMS urged to cut prior authorization red tape
Hospitals seek to stop January Medicare reimbursement cuts to off-site clinics

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars