Federal Reports

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Cornerstone Hospital of Austin (the Hospital), in Austin, Texas, did not comply with Medicare requirements for billing Kwashiorkor on any of the 54 claims that we reviewed. The Hospital used diagnosis code 260 for Kwashiorkor but should have billed for other forms of malnutrition. The 54 inpatient claims that were coded incorrectly resulted in overpayments of $358,000. The Hospital believed that all claims identified by OIG were appropriately submitted for payment.

From 2011 through 2014, the Louisiana Department of Health made incorrect Herceptin payments to Medicaid providers, which resulted in overpayments of approximately $2.1 million (Federal share).