May Reports: Two Missouri Hospitals Overbilled Medicare $900k

FOR IMMEDIATE RELEASE                                                

CONTACT: Kristin Walter
(202) 898-0995

May Reports: Two Missouri Hospitals Overbilled Medicare $900k

Washington, D.C. – Two reports released in May 2015 by the Office of Inspector General found that Missouri hospitals overbilled Medicare $900,000.

According to the OIG, Saint Luke’s Hospital of Kansas City improperly billed Medicare in 27 percent of claims, resulting in overpayments of $581,218. Another Medicare Compliance Report found Saint Anthony’s Medical Center improperly billed Medicare in 20 percent of claims, resulting in overpayments of $308,853.

Recently released analysis by the Council for Medicare Integrity found that Missouri providers overbilled Medicare by $170 million in 2013, ranking the state at no. 4 on its list of the Worst States for Medicare Waste.

Meanwhile, Missouri lawmakers recently introduced a bill that will weaken a vital Medicare oversight program, putting Medicare in jeopardy for the 833,445 Missouri beneficiaries that rely on the program every day.

Since 2011, the rate of Medicare improper payments has risen steadily from 8.6 percent to 12.7 percent, with a Medicare Trust Fund loss of $46 billion in FY2014 alone. Because of this trend, healthcare officials estimate the Medicare Trust Fund will be insolvent by 2030.

According to a recent hearing statement by Sen. Claire McCaskill (D-MO), the Recovery Audit Contractor (RAC) program, which examines just 2 percent of a provider’s Medicare claims, has recovered nearly $10 billion in improper Medicare payments since the program began, extending the financial viability of the Medicare Trust Fund by two years. However, due to recent constraints on the program, overpayment recoveries are now at their lowest level in RAC program history.

In 2009, Congress implemented the RAC program nationwide to review post payment Medicare claims and claw back funds that were inappropriately paid from the Medicare Trust Fund. Recovery auditors today maintain a 96 percent accuracy rate.

“It seems rather incredulous that not only can hospitals cry ‘burden’ when Recovery Auditors look at only 2 percent of all Medicare claims, but that members of Congress would support these claims by introducing legislation to weaken an already restricted oversight program,” said Kristin Walter, spokesperson for the Council for Medicare Integrity. “It is Congress’ responsibility to look out for the best interest of the taxpayer and that means looking out for the longevity of Medicare, not the special interest groups that spend millions on lobbying efforts in Washington.”

For more information, please visit: www.medicareintegrity.org.

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About the Council for Medicare Integrity

The Council for Medicare Integrity is a 501(c)(6) non-profit organization. The Council’s mission is to educate policymakers and other stakeholders regarding the importance of healthcare integrity programs that help Medicare identify and correct improper payments.

As a 501(c)(6) organization, the Council files IRS Form 990s annually with the IRS as required by law. Copies of these filings and exemption application materials can be obtained by mailing your request to the Secretary at: Council for Medicare Integrity, Attention: Secretary, 9275 W. Russell Road, Suite 100, Las Vegas, Nevada 89148. In your request, please provide your name, address, contact telephone number and a list of documents requested.  Hard copies are subject to a fee of $1.00 for the first page and $.20 per each subsequent page, plus postage, and must be made by check or money order, payable to the Council for Medicare Integrity. Copies will be provided within 30 days from receipt of payment. These documents are also available for public inspection without charge at the Council’s principal office during regular business hours. Please schedule an appointment by contacting the Secretary at the address above.


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