The hospital failed to comply with Medicare billing requirements for 38 of 100 inpatient and outpatient claims reviewed, the OIG found. The billing errors allegedly resulted in overpayments of $705,976 for the period reviewed. Based on results of the 100-claim sample, the OIG estimated that Jewish Hospital was overpaid $13.5 million during the audit period of 2017 to 2018.
The OIG provided several recommendations to the hospital, including that it should refund Medicare $13.5 million, report and return any additional overpayments, and strengthen its policies to ensure compliance with Medicare’s billing requirements.
In written comments to the OIG’s draft report, the hospital disputed almost all of the OIG’s findings except for billing errors identified in three outpatient claims.
After reviewing the hospital’s objections and comments, the OIG maintained its findings and recommendations.
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