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News Briefs: July 19, 2021

In a new provider compliance audit,[1] the HHS Office of Inspector General (OIG) said Lake Hospital System in Concord, Ohio, was overpaid about $862,000 in 2017 and 2018. OIG audited a stratified random sample of 100 claims and found errors on 51 of them. “On the basis of our sample results, we estimated that the Hospital received overpayments of at least $4,385,974 for the audit period,” OIG said. In large part, the OIG contends, “the hospital incorrectly billed Medicare Part A for beneficiary stays that did not meet Medicare criteria for acute inpatient rehabilitation.” The hospital disagreed with most of OIG’s findings. In a written response, the hospital said OIG’s independent medical reviewer “subjectively or inaccurately” applies Medicare’s inpatient rehabilitation facility coverage criteria to its services.

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