OIG tags Carolinas Medical Center for incorrect billing

Carolinas Medical Center in Charlotte, N.C., failed to comply with Medicare billing requirements for 83 of 240 inpatient claims reviewed by HHS’ Office of Inspector General, according to a recent OIG report.

The 83 claims that did not comply with Medicare billing requirements resulted in the hospital receiving $331,831 in combined overpayments during 2014 and 2015, according to the OIG.

Extrapolating from the sample results, the OIG estimated Carolinas Medical Center received $1.7 million in overpayments from Medicare during the audit period.

Based on its findings, the OIG recommended the hospital refund Medicare $1.7 million, exercise reasonable diligence to identify and return any additional overpayments received outside of the audit period, and strengthen controls to ensure full compliance with Medicare requirements.

In written comments on the draft report, the hospital disagreed with some of the OIG’s findings and said the extrapolation of the OIG’s results was invalid.

After reviewing Carolinas Medical Center’s written comments, the OIG maintained its findings and recommendations.

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