A new OIG report found CMS did not reconcile hospital outlier payments associated with 292 of the 305 cost reports that were referred to it by nine selected Medicare contractors, which prevented the Medicare contractors from reaching final settlement of the 292 cost reports. Payments were due from hospitals to Medicare for 236 of the reports, representing funds that should have been returned to Medicare. Payments were due from Medicare to hospitals for the other 56 cost reports, which the OIG observes “could have affected those hospitals’ financial viability.” The OIG offered a series of recommendations to ensure that Medicare reconciles outlier payments and performs final settlement in accordance with federal regulations and guidance. CMS concurred with the OIG’s recommendations and described its corrective actions in the OIG report, “The Centers for Medicare & Medicaid Services Did Not Reconcile Medicare Outlier Payments in Accordance With Federal Regulations and Guidance.”
Register Now As you are not an existing subscriber please register for your free daily legal newsfeed service.Register
If you have any questions about the service please contact firstname.lastname@example.org or call Lexology Customer Services on +44 20 7234 0606.
OIG examines CMS reconciliation of Medicare hospital outlier payments
If you are interested in submitting an article to Lexology, please contact Andrew Teague at email@example.com.
Group Manager, Legal and Business Services
Australian Grand Prix Corporation