Hospitals received at least $5.7 million in inappropriate Medicare reimbursement for intensity-modulated radiation therapy services, according to a new report from HHS' Office of Inspector General.
In its report, the office reviewed claims paid to hospitals from the National Government Services, a contractor for Medicare providers.
The office found that National Government Services incorrectly paid hospitals for nearly all the Medicare beneficiaries it reviewed.. While most of the radiation therapy services billed by hospitals were allowable, National Government Services made overpayments for at least one service for 99 of the 100 beneficiaries in its random sample.
Overpayments occurred because system edits didn't prevent NGS from paying hospitals for incorrectly billed radiation services and "hospitals were unfamiliar with, or misinterpreted Medicare guidance when billing for IMRT services, or cited clerical errors," the federal report states.
The office recommended three ways for National Government Services to recover overpayments and made two procedural recommendations for properly billing for radiation services.