Contractor overpays Massachusetts hospitals
Compliance Monitor, January 25, 2007
Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!
Associated Hospital Service (AHS), a Medicare contractor based in Maine, made inaccurate payments for claims, according to a recent OIG audit.
AHS made full diagnosis-related group payments for claims that should have been reduced to short-stay outlier payments. The claims also should have been reduced by the beneficiaries' co-insurance amounts for lifetime reserve days.
AHS paid more than $936,000 for 83 claims to eight long-term care hospitals in Massachusetts. The services covered were performed between January 1, 2003 and April 30, 2004. This happened because the intermediary did not ensure that the hospitals' claims contained the appropriate coverage status codes.
As part of the OIG's recommendation to resolve the inaccuracies, AHS agreed to recover the overpayments made to the eight hospitals.
Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!
Related Products
-
Strategies for Health Care Compliance
News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...
-
Compliance Monitor
This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...
-
Medicare Weekly Update
Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...
-
Medicare Update for Physician Services
Medicare Update for Physician Services is a free, monthly e-zine that delivers news and information to help physician...
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Identify potential Medicaid RAC target areas
- HIPAA Q&A: Level of encryption needed for email
- Topic: CMS, OESS post new security compliance review information, checklist
- Capturing all necessary codes for IUD insertion and removal can be challenging
- What does case-mix index mean to you?
- OB services: Coding inside and outside of the package
- QA:Coding multiple initial infusions
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- CMS has reformulated payments for some bilateral procedures
- HIPAA Q&A: Level of encryption needed for email
- Q&A: Follow CMS' coding guidelines when using modifier -25
- What does case-mix index mean to you?
- Catch up on what's new with injections and infusions
- New conflicts of interest create new challenges
- Q/A. One injection code or two?
- Do not code 57288 with 52000
- Searched