Billing Medicare for services under the wrong physician names and National Provider Identifiers and submitting claims for nonphysician services under a physician’s NPI got an Alaska hospital in hot water with the HHS Office of Inspector General (OIG), underscoring all the different ways compliance can go awry. Bartlett Regional Hospital, an administrative division of the City and Borough of Juneau, agreed to pay $1.434 million for allegedly violating the civil monetary penalties law, according to the settlement. Bartlett Regional Hospital filed a self-disclosure with OIG in October 2012, saying that “it had submitted unallowable charges for emergency department physician services to the Medicare and Medicaid programs.” After an investigation and audit, the hospital discovered $648,227 in unallowable charges to Medicare and $308,206 in unallowable charges to Medicaid between May 25, 2006, and April 2012, the settlement says.
The hospital did not admit liability in the settlement. And the hospital didn’t return a call requesting comment, so the exact nature of the alleged billing errors is unclear.
Meanwhile, CMS is stepping up its oversight of enrollment and certain billing problems, such as incident-to billing, so providers may want to consider increasing their oversight as well.
Does your hospital audit its incident-to billing?
Want to publish your own articles on DistilINFO Publications?
Send us an email, we will get in touch with you.
Are you putting more energy into the enrollment form and the required updates?