Daily Journal: NMMC, UMMC tagged for overpayments in Medicare audits NMMC, UMMC tagged for overpayments in Medicare audits

NMMC, UMMC tagged for overpayments in Medicare audits

Daily Journal

TUPELO – North Mississippi Medical Center-Tupelo has agreed to repay Medicare $119,000 following the findings of audits of large hospitals around the country.

University of Mississippi Medical Center in Jackson, which also was chosen for the Medicare audit of large hospitals, was asked to return $365,000.

“Of all the reported audits of hospitals nationwide, NMMC had one of the lowest error rates,” according to the statement released Wednesday afternoon by the Tupelo hospital.


The auditors working for the U.S. Department of Health and Human Services Office of Inspector General reviewed 237 inpatient and outpatient claims filed by NMMC from 2013 and 2014. They found 79 claims that resulted in $41,000 in overpayments.

Based on the sample, they determined that NMMC likely received $119,000 in overpayments in the audit period, according to the inspector general’s office.

NMMC said the overpayments fell into two categories. The first set involve the use of EEG tests, which measure the electrical activity in the brain; the auditors challenged the EEG tests given to cardiac patients after surgical procedures.

“While NMMC physicians believe EEG tests are appropriate, (the Centers for Medicare and Medicaid) did not feel the tests were necessary,” according to the NMMC statement.

The second set involve five cases where NMMC did not credit Medicare for rebates from medical device manufacturers.

“NMMC has already taken the necessary steps to improve its processes to assure these overpayments do not occur in the future,” according to a statement released by the hospital.


For UMMC, the auditors found 80 claims out of 217 reviewed that resulted in overpayment of $68,000. Based on the sample, the auditors estimated UMMC had received overpayments of at least $365,000.

“We have reviewed and accepted the (Office of the Inspector General’s) recommendations and have implemented appropriate actions to prevent those type of billing errors in the future to ensure full compliance with Medicare requirements,” UMMC officials said in a written statement on Wednesday.

Read the original story here.

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