OIG tags 2 Mississippi hospitals for incorrect billing

Mississippi Medical Center in Jackson and North Mississippi Medical Center in Tupelo failed to comply with Medicare billing requirements for a portion of claims reviewed by HHS' Office of the Inspector General for the audit period of Jan. 1, 2013, through Dec. 31, 2014, according to recent OIG reports.  

Mississippi Medical Center
Mississippi Medical Center failed to comply with Medicare billing requirements for 80 of 217 inpatient and outpatient claims reviewed by the OIG. The billing errors resulted in the hospital receiving $67,942 in overpayments, according to the OIG.

Extrapolating from the sample results, the OIG estimated Mississippi Medical Center received at least $356,766 in overpayments from Medicare during the audit period.

Based on its findings, the OIG recommended the hospital refund the Medicare contractor $356,766, 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, Mississippi Medical Center did not agree with the OIG's determinations regarding two outpatient claims.

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

North Mississippi Medical Center  
North Mississippi Medical Center failed to comply with Medicare billing requirements for 79 of 237 inpatient and outpatient claims reviewed by the OIG.

The billing errors resulted in the hospital receiving $40,849 in overpayments, according to the OIG.

Extrapolating from the sample results, the OIG estimated North Mississippi Medical Center received at least $119,365 in Medicare overpayments during the audit period.

The OIG recommended North Mississippi Medical Center refund the Medicare contractor $119,365, 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.

The hospital agreed with all but one of the OIG's findings and said it is in the process of refunding the overpayment.

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

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