The OIG audit report on Lahey, a 317-bed teaching hospital of Tufts University School of Medicine, found billing errors on several outpatient and inpatient claims, resulting in Medicare overpayments of $736,220. Somerset Hospital, a 150-bed hospital, likewise had billing errors on outpatient and inpatient claims, leading to Medicare overpayments of $313,443.
Officials for Somerset Hospital concurred with the OIG’s audit and will refund the overpayments.
Lahey officials agreed with most of the OIG’s recommendations, including refunding Medicare, but argued the hospital did not incorrectly bill 11 claims for inpatient short stays. However, the OIG said it maintained its position that those stays did not meet the medical necessity requirements for inpatient admissions.
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