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Other Issuances: OIG audits outpatient lithotripsy billing, high-dollar claims, and more

Medicare Weekly Update, May 4, 2010

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OIG audits high-dollar inpatient claims

On April 21, the OIG issued a report on high-dollar payments for inpatient services processed by Noridian Administrative Services, LLC, between 2003 and 2005. The OIG determined that of the 415 high-dollar Medicare payments ($200,000 or more) Noridian made to hospitals for inpatient services during these years, 306 were appropriate. The 109 remaining payments included net overpayments totaling $3 million.

View the OIG report.

OIG audits payments to terminated providers

On April 20, the OIG issued a review of payments made by National Government Services, Inc., to terminated providers. The OIG determined that NGS did not always recover Medicare overpayments for services furnished on or after the effective termination dates of provider agreements or during termination-related Denial of Payment for New Admissions sanction periods.

View the OIG report.

OIG audits lithotripsy claims

On April 19, the OIG issued a review of payments for outpatient lithotripsy services provided at the George Washington University Hospital in Washington, DC. The OIG determined that the hospital received overpayments totaling $32,000 for 39 outpatient lithotripsy services because it billed for the same lithotripsy service using multiple revenue codes.

View the OIG report.

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