Report on Medicare Compliance Volume 29, no. 22 (June 15, 2020):
◆ The HHS Office of Inspector General has updated its Work Plan,[1] and new items include opioid treatment challenges during the COVID-19 pandemic.
◆ In a provider compliance audit,[2] the HHS Office of Inspector General (OIG) said Ohio State University Hospital in Columbus, Ohio, was overpaid $335,832 in 2016 and 2017. “On the basis of our sample results, we estimated that the Hospital received overpayments of at least $3.7 million for the audit period,” OIG said. OIG reviewed 145 Medicare claims and said the hospital, which is part of the Ohio State Wexner Medical Center, wasn’t compliant with 47 of them. Among the errors, according to OIG: the hospital incorrectly billed for inpatient rehabilitation that wasn’t reasonable and necessary and incorrectly billed Medicare for right heart catheterizations performed during the same patient encounter as heart biopsy procedures. In a written response, Kathleen Ojala, administrative director for compliance and integrity at Ohio State Wexner Medical Center, agreed some of the claims were incorrect and they have been repaid. However, she objected to OIG’s use of extrapolation. “OIG’s audit design and methodology is flawed,” and “OIG did not adhere to its own auditing methodology.”
1 “Recently Added,” Work Plan Home, HHS OIG, accessed June 12, 2020, https://go.usa.gov/xwXzy.
2 HHS OIG, Medicare Hospital Provider Compliance Audit: The Ohio State University Hospital, May 2020, https://go.usa.gov/xw88M.
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