The OIG looked at claims from the 583-bed hospital from 2010 and 2011. Most of the errors came on the inpatient side, as the agency found Sanford submitted claims to Medicare with incorrect diagnosis-related codes and stays that should have been billed as outpatient or observation, among other errors. Sanford attributed the errors to coders misinterpreting clinical documentation and staff misunderstanding Medicare’s inpatient and outpatient criteria.
Sanford has already paid back the money to CMS and said it has taken “corrective actions” to ensure compliance in the future.
More Articles on Hospitals and Medicare Overpayments:
OIG Slams 3 Hospitals, Health Systems for $2.3M in Medicare Overpayments
OIG: Hospital of the University of Pennsylvania Must Refund $538k
Community Medical Center in Montana Refunds $158k for Incorrect Outpatient Billing
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