Oregon Health Forum, March 1998
http://www.healthforum.org/march.html


Hospitals fined $502,516 for overbilling Medicare

Oregon hospitals have paid $502,516 to the federal government during
the last four months after double billing Medicare for diagnostic
services. As part of their settlement agreement, hospitals must
review their patient accounts and refund payments made by
beneficiaries.

"This shows how the professionals are gaming the system," said Ben
St. John with the Office of Inspector General. Responded Ken Rutledge
of the Oregon Assn. of Hospitals and Health Systems: "It's good
publicity for them. Basically it's a shake-down operation."

SUMMARY: The U.S. Office of Inspector General has recovered $50.2
million from 1,795 hospitals in 24 states; the hospitals were
charged with violating Medicare rules that say hospitals cannot
bill for laboratory and other tests done 72 hours prior to
admission. Three audits were conducted in Oregon from 1983 through
1990, and when a fourth audit revealed hospitals were still
overbilling, the Justice Department launched an investigation in
1994. Despite the crackdown, a fifth audit during 1997 revealed
hospitals were continuing to double bill.