Geisinger Medical Center in Danville, Pa., has agreed to pay the federal government $1.3 million to resolve allegations of improper Medicare billing, according to a Daily Item report.
The alleged overbilling took place from Jan. 2001-Dec. 2006. U.S. Attorney Peter J. Smith claimed the hospital submitted Medicare claims that contained management services not allowable under Medicare requirements.
More specifically, Medicare doesn’t normally issue additional payments for management services offered by a provider the same day a procedure is performed. These “Modifier 25” services were allegedly incorrectly attached to Geisinger’s claims, resulting in Medicare’s overpayment.
Geisinger said the $1.3 million represents 0.138 percent of the company’s total Medicare billings from 2001-2006. Geisinger and the Department of Justice noted that the hospital had voluntarily refunded more than $510,000 in overpayments in the past. Geisinger had also changed its billing practice before being contacted by the government.
Read the Daily Item report on Geisinger Medical Center’s settlement.
Related Articles on Hospitals and Settlements:
N.C. Baptist Hospital Pays $5.4M to Settle Claims of Overbilling Employees for Health Coverage
Tenet Moves Toward $25M Settlement Over Hurricane Katrina Lawsuit
4 Kentucky Providers Will Repay $26.4M to Passport Health Plan as Part of Settlement
At Becker's 4th Annual CEO + CFO Roundtable, taking place November 2–5 in Chicago, more than 1,500 hospital and health system executives tackle decisions that determine whether organizations thrive or merely survive: protecting margins under cost pressure, choosing where to grow, renegotiating payer relationships, stabilizing the workforce and proving real ROI on technology. This is where leaders work through them together, face-to-face. Apply for complimentary registration now.