OIG: Robert Packer Hospital Must Refund $1.9M to Medicare

Robert Packer Hospital, the 254-bed teaching hospital within Guthrie Health in Sayre, Pa., will have to repay approximately $1.88 million in Medicare funds back to the government, according to an audit from the HHS Office of Inspector General.

OIG officials looked at claims at the hospital for services provided between 2009 through 2011. More than one-third of the examined claims had billing errors, according to Medicare policy, which resulted in $1.88 million. Most of the errors came on the inpatient side, specifically for claims that billed Medicare Part A for services that should've been treated on an outpatient basis. Robert Packer Hospital also billed Medicare using DRG codes that could not be supported by documentation, according to the audit.

In response, Guthrie executives said they agreed that 16 of the 99 claims were incorrectly billed, but they argued the remaining claims did not have errors. "The hospital said that it had a vigorous process to review and confirm the appropriateness of inpatient admissions," the audit read.

Guthrie plans to appeal those claims, but the OIG said it stood by its findings and expects the hospital to refund all outlined reimbursements.

More Articles on Hospitals and Medicare:
OIG: Sutter Health's Flagship Incorrectly Billed Medicare $1M
OIG: Incorrect Clinic Claims Rampant at Hospitals
OIG Audits 3 Christus Hospitals, Finds $3.3M in Medicare Overpayments

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