Good afternoon to all from Washington, DC. Today OIG posts two reports and news about enforcement actions. As always, you can use the links provided to go directly to the new material. ------------------------------------------------------------------------------ Medicare Compliance Review of the University of Colorado Hospital for Calendar Years 2008 and 2009 (A-07-11-05009) http://go.usa.gov/vj6 The University of Colorado Hospital (the Hospital), located in Aurora, Colorado, complied with Medicare billing requirements for 136 of the 164 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 28 claims, resulting in overpayments totaling $309,000 for calendar years 2008 through 2010. Overpayments occurred primarily because the Hospital did not have adequate controls to prevent the incorrect billing of Medicare claims. ------------------------------------------------------------------------------
Medicare Compliance Review of New York Downtown Hospital for the Period July 1, 2008, Through December 31, 2010 (A-02-11-01022) http://go.usa.gov/vj7 New York Downtown Hospital (the Hospital) complied with Medicare billing requirements for 128 of the 186 claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for 58 selected inpatient and outpatient claims, resulting in overpayments totaling $423,978. Specifically, 22 inpatient claims had billing errors, resulting in overpayments totaling $423,978, and 36 outpatient claims had billing errors that did not result in any overpayments. Overpayments occurred primarily because the Hospital did not have adequate controls to prevent incorrect billing of Medicare claims and its staff did not fully understand the Medicare billing requirements. ------------------------------------------------------------------------------ Updated Civil Monetary Penalty Case Summaries False and Fraudulent Claims http://go.usa.gov/vjF Patient Dumping http://go.usa.gov/vjM ------------------------------------------------------------------------------ June 15, 2012; U.S. Department of Justice Brooklyn Doctor Convicted for Role in Medicare and Private Insurance Fraud Scheme http://go.usa.gov/yWn ------------------------------------------------------------------------------ State Enforcement Actions Updated http://go.usa.gov/pqp ------------------------------------------------------------------------------ That’s all we have for today. If we can be of any further assistance, please send an Email to public.affairs@oig.hhs.gov I hope your week has started well. Marc Wolfson – Office of External Affairs OIG’s privacy policy can be found at http://oig.hhs.gov/notices/privacy-notice.asp
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OIG Posts 2 Reports and News about Enforcement Actions - 6/18
