Health Headlines: Also in the News - May 2014

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OIG Reports Jurisdiction H Contractors Made $3.3 Million in Overpayments for Outpatient Drugs – According to a recent OIG report, the Medicare Contractors for Jurisdiction H overpaid providers approximately $3.3 million for certain outpatient drugs.  OIG selected 1,905 line items for review from a July 1, 2009 - June 30, 2012 audit period, and found 1,126 to be incorrect based on incorrect units of service and/or incorrect HCPCS codes, failure to provide supporting documentation, billing separately for an outpatient drug for which payment was packaged with a primary service, and billing for a noncovered use of a drug.  Novitas Solutions, Inc., the current contractor for Jurisdiction H, indicated it would pursue recovery of the overpayments and educate providers on the correct billing of outpatient drugs.

Hospital Company Observes Increase in Medicaid Admissions Following Affordable Care Act Implementation – Tenet Healthcare Corporation reported an increase in Medicaid admissions in states that elected to expand coverage under the Affordable Care Act (ACA), according to the Texas-based hospital company’s recently released earnings for Q1 2014.  Over the January - March 2014 period, Tenet observed a 17 percent increase in Medicaid admissions for its hospitals “in the four states that expanded Medicaid eligibility effective January 1, 2014 under the [ACA].”  Tenet also reported a 33 percent decline in uninsured plus charity admissions over the same period in the same four states.  You can view Tenet’s press release regarding its Q1 2014 earnings here

 

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OIG

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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