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South Shore Hospital in Miami subject of OIG proposed exclusion

Compliance Monitor, December 14, 2005

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The OIG has notified Miami's South Shore Hospitals and Medical Center that it is moving to exclude it from Medicare, Medicaid and all other Federal health care programs, according to a press release issued by the OIG.

The action was in response to the facility's alleged violation of a corporate integrity agreement (CIA) it negotiated with the OIG in 2002 in addition to a $937,000 settlement for allegedly overcharging Medicare by submitting false cost reports for unallowable costs.

According to the OIG the facility has since failed to submit complete, accurate annual reports and didn't comply with the recommendations of the CI, which called for specific "cost report reviews" and "engagement procedures."

"The decision to issue a proposed exclusion letter to South Shore was made after careful consideration of the facts and circumstances regarding the actions of this hospital," said Inspector General Daniel R. Levinson. "In the majority of cases provider organizations comply with the terms of the CIA. However, South Shore's repeated egregious failure in this case to abide by the terms of its CIA requires the OIG for the first time to seek exclusion for such a violation."

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