The 58 claims that did not comply with Medicare billing requirements resulted in the hospital receiving $293,404 in combined overpayments during the audit period of Jan. 1, 2016, through Dec. 31, 2017, according to the OIG.
Extrapolating from the sample results, the OIG estimated St. Vincent Hospital received at least $2.1 million in overpayments from Medicare during the audit period.
Based on its findings, the OIG recommended the hospital refund Medicare $2.1 million, exercise reasonable diligence to identify and return any additional overpayments received outside of the audit period, and strengthen controls to ensure full compliance with Medicare requirements.
In written comments on the draft report, St. Vincent Hospital generally disagreed with the OIG’s findings and recommendations. The hospital said it would appeal the findings for 16 claims, representing $267,989 in overpayments.
After reviewing the hospital’s comments, the OIG maintained its findings and recommendations.
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