The 94 claims that did not comply with Medicare billing requirements resulted in the hospital receiving $494,000 in overpayments, according to the OIG. Based on the sample results, the OIG estimated that Florida Hospital Orlando received at least $11.5 million in overpayments from Medicare during the audit period.
Based on its findings, the OIG recommended the hospital refund the Medicare contractor $11,512,530 in estimated overpayments and strengthen its controls to ensure full compliance with Medicare requirements.
Florida Hospital Orlando disagreed with the OIG’s findings. The hospital contended that it did not improperly bill 70 of the 94 improper claims the OIG identified in its audit. The hospital also objected to the lack of clarity in the OIG’s findings and the OIG’s use of sampling and extrapolation to calculate the overpayment.
After receiving the hospital’s comments and objections, the OIG maintained its findings and recommendations.
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