The overcharges were identified by an audit that the health plan began in March after learning that some hospitals had failed to notify the plan about rate increases for outpatient services as required by the health plan’s contracts, according to the report.
Ninety hospitals in the state were reviewed or are currently under review, and 30 were found to have billed properly. The six hospitals required to repay the health plan include Wayne Memorial Hospital in Goldsboro, N.C., which owes more than $1 million, and Johnston Memorial Hospital in Smithfield, N.C., which owes $229,675, according to the report.
More hospitals may be identified for overcharges as the reviews continue.
Some of the hospitals that allegedly overcharged the plan claim that they notified BCBS of the rate increases, assuming the information would be passed along to the health plan, according to the report.
Read the News & Observer’s report on North Carolina hospitals overcharging the state health plan.
