OIG: NorthShore University HealthSystem received $4.1M in Medicare overpayments

Evanston, Ill.-based NorthShore University HealthSystem failed to comply with Medicare billing requirements for 93 of 190 inpatient and outpatient claims reviewed by HHS' Office of Inspector General for the audit period of Jan. 1, 2013, through Dec. 31, 2014, according to a recent OIG report.

The billing errors resulted in NorthShore receiving $624,638 in overpayments, according to the OIG. Extrapolating from the sample results, the OIG estimated NorthShore received at least $4.1 million in overpayments from Medicare during the audit period.

Based on its findings, the OIG recommended NorthShore refund the Medicare contractor $4.1 million, exercise reasonable diligence to identify and return any additional overpayments outside of the audit period and strengthen controls to ensure full compliance with Medicare requirements.

In written comments, NorthShore disagreed with the OIG's findings and recommendations.

After reviewing the system's comments, the OIG maintained its findings and recommendations.

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