OIG tags Baylor Scott & White hospital for billing errors

Baylor Scott & White-College Station (Texas) didn't properly bill for supplemental outlier payments from Medicare, according to a Sept. 3 report from HHS' Office of Inspector General.

Medicare outlier payments are designed to shelter hospitals from significant losses should patients require extraordinary care costs. The OIG reviewed outlier payments that CMS made to Baylor Scott & White-College Station because the hospital's outlier payments increased from $82,555 in 2015 to $2.6 million in 2016. 

The OIG sampled 100 outlier payments from an audit of 669 payments that totaled $2.1 million. The agency found Baylor Scott & White-College Station only properly billed for 18 of the 100 sampled payments. The remaining contained 174 billing errors that led to overpayments. 

The OIG said the errors primarily stemmed from inadequate oversight of overcharged observation time, charge errors and coding issues. The agency recommended that the hospital repay $189,276 to its Medicare contractor and improve billing procedures. Baylor Scott & White-College Station said it has or plans to implement more policies to address the issue.

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