By Rachel Stoltzfoos, DCNF
U.S. taxpayers lost about $7.5 million in Medicare overpayments to two hospitals in a year and half.
The Department of Health and Human Services erroneously paid a New Jersey hospital at least $1.5 million, and a Tennessee hospital at least $5.8 million in Medicare payments between April 2011 and September 2012, the HHS Inspector General reported Wednesday.
The IG identified a large pool of payments most likely to be incorrect — based on its experience auditing other hospitals — then examined a smaller sample. Many of the improper payments were because the hospital either charged for something not covered by Medicare, or it incorrectly identified the services it had offered and then overcharged Medicare.
Hackensack University Center billed Medicare for removing teeth, which isn’t covered by Medicare, and charged Medicare to replace a device in a patient that it was later reimbursed for. Methodist Healthcare sometimes charged for the wrong service, as in some cases where it charged someone as an inpatient rather than an outpatient.
In a review covering 7.6 million in Medicare payments to Hackensack University Medical Center for 1,553 patients, the IG identified $352,000 in specific overpayments for 62 claims, and estimates it received $1.5 million total.
In a similar review covering $29 million in Medicare payments to Methodist Healthcare – Memphis Hospitals for 3,590 patients, the IG identified $353,000 specific overpayments for 48 claims, and estimates it received $5.8 million total.
“The truth of the matter is that this is so common within the Medicare program it’s not even funny,” Bob Moffit, a senior fellow in the Heritage Foundation’s Center for Health Policy Studies, told The Daily Caller News Foundation.