The OIG looked at 282 claims from 2010 and 2011 at St. Elizabeth’s. Of that total, the agency said 225 claims did not comply with Medicare guidelines. Most came on the inpatient side and involved medical necessity and incorrectly billing for inpatient payment when the patient should have been billed as outpatient or observation.
Steward and St. Elizabeth’s mostly agreed with the OIG’s findings, though officials said they intend to appeal eight inpatient claims they believed were not incorrectly billed. Kevin Hannifan, president of St. Elizabeth’s, also wrote in a letter the hospital will continue to strengthen its internal controls and is “confident that our corrective actions will address the identified errors.”
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