Medicare pays outpatient providers twice, leading to $6M overpayments

Fiercehealthcare.com: June 15, 2012 | By Alicia Caramenico

 

Medicare continues to pay twice for nonphysician outpatient services before and during inpatient stays, according to a report from the U.S. Department of Health & Human Services’ Office of Inspector General, released last week.

Medicare overpaid hospital outpatient providers by about $6.4 million in 2008 and 2009 for services provided within three days prior to the date of admission, on the date of admission or during inpatient prospective payment system (IPPS) stays.

Although Medicare correctly paid for 66 of the 127 nonphysician outpatient services that OIG reviewed, it paid providers twice for 61 services, resulting $340,073 worth of overpayments, the agency said.

According to the report, the overpayments stemmed from hospitals incorrectly billing Medicare Part B for outpatient nonphysician services such as laboratory services and radiology and surgical procedures.  Read more