Mary Hitchcock Memorial Hospital Overbilled Medicare $1.4 Million

FOR IMMEDIATE RELEASE                                                
August 10, 2015            

CONTACT: Kristin Walter
(202) 898-0995

Mary Hitchcock Memorial Hospital Overbilled Medicare $1.4 Million

Washington, D.C. – A report released this week by the Office of Inspector General found that Mary Hitchcock Memorial Hospital in Lebanon, New Hampshire overbilled Medicare by $1,393,198.

According to the OIG, the hospital improperly billed Medicare in 57 percent of claims.

The most recent Centers for Medicare and Medicaid Services (CMS) report on recovery auditing found New Hampshire overbilled Medicare by $9 million in 2013. This is a $5 million increase from 2012.

In 2006, due to rampant waste in the program, Congress mandated a program to prolong the lifespan of the Medicare Trust Fund: The Recovery Audit Contractor (RAC) program.

The RAC program looks at just 2 percent of Medicare claims to identify services that are either not medically necessary or coded improperly according to Medicare policy. As a result, the RAC program has returned more than $10 billion to the Medicare Trust Fund and extended its lifetime by two years. In addition, through their reviews RACs have returned more than $800 million in underpayments to providers.

Due to restraints placed on the program, new CMS quarterly reports demonstrate a drastic drop in the recovery of misbilled Medicare funds over the past several quarters. This is especially alarming since a recent  Government Accountability Office (GAO) report showed that Medicare improper payments represent the highest rate of financial waste government-wide, with an estimated $46 billion lost in FY2014 alone.

Due to the youngest of the baby boom generation enrolling in Medicare over the next 15 years and living longer, the cost per individual’s lifetime will double. Add this to the staggering loss of Medicare funds due to provider billing errors and the Medicare Trustees have reported that the Trust Fund will be bankrupt by 2030 – just 15 years from now.

“As important as the Medicare program is to our nation, it’s appalling that the hospital industry is happy to continue to knowingly pocket $46 billion per year of improperly billed taxpayer dollars that would otherwise extend the life of the program for our most vulnerable citizens,” said Kristin Walter, spokesperson for the Council for Medicare Integrity.  “Similarly, it’s surprising that Congress is comfortable with the ongoing waste of billions of taxpayer dollars that fund this program. It’s the responsibility of our nation’s leaders to look out for the best interest of the taxpayer and that means protecting the longevity of Medicare, not the special interest groups that spend millions lobbying in Washington to protect their profits. It’s time to permit Recovery Auditors to work at their full potential to return these wasted funds back to the program where they belong.”

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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