Medicare Compliance & Reimbursement

Hospitals that consolidate their operations need to make sure their subsequent Medicare billings don't run afoul of related Medicare rules.

The HHS Office of Inspector General makes that point in a recent audit report focusing on the consolidation of two New Orleans facilities. In "Review of Compliance with Medicare Regulations Related to the Consolidation of University Hospital and the Medical Center of Louisiana at New Orleans" (A-06-02-00012), the OIG found that the surviving post-consolidation hospital ended up with about $1.8 million in overpayments.

The culprit: The facilities continued to use University's provider number even though MCLNO was the surviving hospital - and thus, under Medicare rules, the only facility whose provider number should be used. The OIG points out that much of the overpayment arose from transfers between the consolidated hospitals.

To see the report, go to http://oig.hhs.gov/oas/reports/region6/60200012.pdf.