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.
More Articles on Medicare Overpayments:
Medicare RACs, Hospitals Spar Over New Fraud Legislation
North Shore Medical Center Overbilled Medicare $816k
Audit: St. Luke’s Boise Medical Center Overbilled Medicare by $83k
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
