OIG Report: Lafayette General Medical Center Overbilled Medicare By $4.4 Million

FOR IMMEDIATE RELEASE                                                                

CONTACT: Kristin Walter
(202) 898-0995

OIG Report: Lafayette General Medical Center Overbilled Medicare By $4.4 Million

Washington, D.C. – A report released this week by the U.S. Department of Health and Human Services Office of Inspector General (OIG) found that Lafayette General Medical Center in Lafayette, Louisiana overbilled Medicare $4,413,989 from 2013 to 2014.  According to the OIG, 51 percent of the hospital’s Medicare claims were improperly billed.

According to the Supplementary Appendices for the Medicare Fee-for-Service (FFS) 2015 Improper Payment Report, Louisiana tops the list of states with above average improper payment rates, overbilling in 19.4 percent of cases – well above the national error rate of 12.1 percent – for a total of $1.25 billion lost from the Medicare Trust Fund stemming from the state alone.

According to the Council for Medicare Integrity, a nonprofit group that advocates for proper Medicare billing, Lafayette General Medical Center’s improper billing is part of a nationwide problem.  Since 2011, the rate of Medicare Fee-for-Service (FFS) improper payments has risen steadily from 8.6 percent to 12.1 percent, with a loss of more $40 billion annually to the Medicare Trust Funds.

In an effort to reduce waste within Medicare, the Recovery Audit Contractor (RAC) Program was put in place by Congress in 2009 to review Medicare FFS post-payment claims to identify and recover improper payments made to providers. The program currently reviews only 0.5 percent of a provider’s post-payment inpatient claims, meaning 99.5 percent of these claims go un-reviewed. 

Senator Claire McCaskill (D-MO), the Chairman and Ranking Member on the U.S. Senate Special Committee on Aging, has credited the RAC Program with returning $10 billion back to the program and extending its life by two years.

“Improper payments are a real cause of concern, especially in light of recent government reports predicting the end Medicare Part A in 2026 – just 10 years from now,” said Kristin Walter, spokesperson for the Council for Medicare Integrity. “As baby boomers in Louisiana increasingly become eligible for Medicare, and life expectancy continues to rise at the same time that costs of medical treatments are increasing, the question becomes, ‘Will Medicare be there when you need it?’”

In a recent interview, House Speaker Paul Ryan (R-WI) pointed to what the end of Medicare would mean for the 55 million Americans who rely on the program for healthcare coverage, “I believe that if we do not prevent Medicare from going bankrupt, it will go bankrupt. And that will be bad for everybody.” 

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.


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