Memorial Hermann will pay $1.9M to settle improper billing allegations

Houston-based Memorial Hermann Health System has agreed to pay the federal government $1.9 million to resolve allegations three of its hospitals improperly billed Medicare for inpatient services provided to beneficiaries that should have been billed as less costly outpatient care, according to the Department of Justice.

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The government alleged that from Jan. 1, 2009, through Dec. 31, 2014, the three hospitals submitted claims to Medicare for scheduled surgical procedures in which the patient’s hospital stay lasted two days or less. The claims should have been submitted to Medicare as outpatient services. This caused the three hospitals to receive more reimbursement from Medicare than they were entitled to, according to the DOJ.

“Charging the government for higher cost inpatient services when patients only require lower cost outpatient services is a waste of taxpayer money and a violation of trust with the patient and with the government,” said U.S. Attorney Ryan K. Patrick. “This settlement should deter similar conduct in the future and help make healthcare more affordable.”

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