Oregon hospitals fined $502,516 for overbilling Medicare

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Oregon hospitals fined $502,516 for overbilling Medicare

Postby Webmaster » February 25th, 2005, 2:52 pm

Oregon Health Forum, March 1998

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.
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