OIG tags Michigan health system for erroneous billing

Ann Arbor-based University of Michigan Health System failed to comply with Medicare billing requirements for 73 of 181 inpatient and outpatient claims reviewed by HHS' Office of Inspector General, according to a recent OIG report.

The 73 claims that did not comply with Medicare billing requirements resulted in the health system receiving $1.3 million in combined overpayments during 2014 and 2015, according to the OIG.

Extrapolating from the sample results, the OIG estimated University of Michigan Health System received at least $6.2 million in overpayments from Medicare during the audit period.

Based on its findings, the OIG recommended the health system refund Medicare $6.2 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, the health system generally agreed with most of the OIG's findings and all of the agency's recommendations. The health system questioned the OIG's overpayment determinations in some instances and also questioned the use of extrapolation for medical necessity findings.

After reviewing University of Michigan Health System's written comments, the OIG maintained its findings and recommendations.

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