Submitting OIG:
Report Description:
Medicare did not appropriately pay acute-care hospitals any of the $51.6 million for outpatient services that we reviewed. In addition, beneficiaries were held responsible for unnecessary deductibles and coinsurance of $14.4 million paid to the acute-care hospitals for outpatient services. Generally, Medicare should not pay an acute-care hospital for outpatient services provided to an inpatient of another facility, such as a long-term-care hospital. Instead, the services should be provided under arrangements between the two facilities, and Medicare should pay the inpatient facility for all services provided to a beneficiary (as part of the facility's inpatient payment rate).
Date Issued:
Monday, September 18, 2017
Agency Reviewed / Investigated:
Submitting OIG-Specific Report Number:
A-09-16-02026
Component, if applicable:
Centers for Medicare & Medicaid Services
Location(s):
Agency-Wide
Type of Report:
Audit
Questioned Costs:
$51,640,728
Funds for Better Use:
$99,149,320
Number of Recommendations:
5
View Document:
Attachment | Size |
---|---|
91602026.pdf | 2.12 MB |
Additional Details Link: