OIG: Mutual of Omaha overpaid claims by $370,000
Healthcare Auditing Weekly, August 7, 2007
An audit of a Midwest intermediary's payments for long-term care hospitals (LTCH) claims found that the intermediary made several overpayments totaling more than $370,000.
The OIG reviewed Mutual of Omaha in the audit. The agency stated that it wanted to see if the intermediary paid LTCH claims in accordance with Medicare requirements when beneficiaries had used all of their regular covered benefit days. In the end, the OIG found that Mutual of Omaha did not always pay accordingly.
As a result, the intermediary made overpayments totaling $374,945 for 33 claims to 21 LTCHs for services provided from January 1 through May 31, 2003.
The OIG recommended that Mutual of Omaha recover the $374,945 in overpayments and work with CMS to determine the appropriate actions for recovering the portion of the overpayments related to the beneficiaries' coinsurance payments. The intermediary generally agreed to implement these recommendations, according to the audit.
Click here to read the entire audit on the OIG's Web site.
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