Medicare overpaid hospitals for defunct heart devices, inspector general says

Medicare has been overpaying hospitals for recalled or faulty heart devices, according to a Nov. 16 report from HHS' Office of Inspector General.

Previous audits from 2005 through 2016 have found that hospitals aren't properly reporting credits they received from manufacturers for defunct cardiac devices. 

In its most recent audit, the inspector general found hospitals likely didn't adjust claims to include credits for recalled devices in nearly half of the 6,558 claims that the office reviewed. The inspector general said this likely led to $33 million in overpayments to 911 hospitals. 

The office recommended several changes to CMS, including payment recovery and implementation of a postpayment review process for Medicare contractors. The agency also asked CMS to require hospitals to use specific condition codes on these types of claims.

More articles on healthcare finance:
Chinese billionaire sells $41M worth of CHS stock
12 hospitals have closed during the COVID-19 pandemic
CommonSpirit posts $800M net income in Q1

© Copyright ASC COMMUNICATIONS 2020. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Featured Webinars

Featured Whitepapers