GOV’T AUDIT INSIDER: Texas clinic overclaimed $12.4 million
Healthcare Auditing Weekly, March 29, 2005
None of the Houston, TX-based Quitman Clinic's 100 sampled claims for partial hospitalization program (PHP) services met Medicare reimbursement requirements, according to an OIG audit report. Because none of the sampled claims were eligible for Medicare reimbursement, the entire universe of 1,714 claims from August 1, 2000, to December 31, 2002, totaling $12.4 million in payments, should not have been billed to Medicare. The OIG recommends that Quitman Clinic refund the unallowable payments to Medicare and strengthen its procedures to ensure that PHP claims meet reimbursement requirements.
During the audit, the OIG did the following:
Click here to read the audit report, "Medical Review of Quitman Clinic's Partial Hospitalization Services for the Period August 1, 2000, Through December 31, 2002," (A-07-04-04034) issued March 1.
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