OIG Finds Medicare Billing Errors at Morton and UCH Memorial Hospitals

Two recent reports from the HHS Office of Inspector General have found billing errors led to Medicare overpayments at two separate hospitals.

At 154-bed Morton Hospital in Taunton, Mass., which is part of Boston-based Steward Health Care System, the OIG said billing errors resulted in $548,451 in incorrect Medicare reimbursements. The agency looked at inpatient and outpatient claims at Morton during 2010 and 2011. About 81 percent of the claims were not compliant with Medicare billing requirements, according to the report. Most errors were due to billing for inpatient services when the hospital should’ve billed for outpatient or observation.

The OIG expects Morton to repay all funds, and the hospital concurred with most of the findings. However, hospital officials said they plan to appeal 12 of the disputed claims.

At Memorial Hospital, a three-campus network within University of Colorado Health in Colorado Springs, the OIG found $161,355 in Medicare overpayments. Similar to Morton, the OIG looked at Memorial’s claims from 2010 and 2011. However, only 30 percent of the claims did not follow Medicare billing protocols.

Memorial said it agreed with most of the OIG’s findings, but it disagreed with the agency’s review of nine outpatient claims. The OIG stood by its results and expects Memorial to refund the full amount.

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