Carolinas HealthCare overbilled Medicare, federal auditor finds - | WBTV Charlotte

Carolinas HealthCare overbilled Medicare, federal auditor finds

Carolinas Medical Center in Dilworth is one of two Carolinas HealthCare System facilities that overbilled Medicare in 2014 and 2015, according to a federal report this month.  (Credit: Davie Hinshaw | The Charlotte Observer) Carolinas Medical Center in Dilworth is one of two Carolinas HealthCare System facilities that overbilled Medicare in 2014 and 2015, according to a federal report this month. (Credit: Davie Hinshaw | The Charlotte Observer)
CHARLOTTE, NC (Deon Roberts/The Charlotte Observer) -

Carolinas HealthCare System overbilled the federal Medicare program an estimated $1.7 million for patients treated at two hospitals near uptown, according to a new federal audit.

The findings on Carolinas Medical Center and CMC-Mercy are part of a report this month from the Department of Health and Human Service’s Office of Inspector General, which routinely conducts similar reviews of U.S. hospitals.

Charlotte-based Carolinas HealthCare, the region’s dominant hospital system, said it plans to appeal the findings.

RELATED: ‘Bigger is not better.’ Experts warn patient costs could rise after NC hospital deal.

According to the report, the two hospitals lacked adequate controls to prevent incorrect billings, the report said. The audit, based on a random sample of 240 Medicare payments in 2014 and 2015, found the hospitals didn’t fully comply with the program’s billing requirements for 83 claims, or about 34 percent.

As a result, Medicare – a key health insurance program for older Americans and those with disabilities – was overbilled $331,831, the report said. Errors resulted in part from some claims being incorrectly coded, according to the report.

Based on its findings from the sample, the inspector general said the two hospitals received at least $1,659,619 in overpayments during the two-year period. The inspector general has recommended the hospitals refund that amount to Medicare.

In its a statement, Carolinas HealthCare said:

“While this audit identified alleged inpatient coding discrepancies in only 5 percent of audited payments, we disagree with many of the findings as well as the methods used to arrive at the ultimate conclusions.”

The hospital system added: “Carolinas HealthCare System prides itself on its strong compliance program – one that, in fact, has been acknowledged by the OIG. Our team works diligently to ensure accurate billing and coding for all claims filed and we have developed comprehensive policies, procedures and education both to prevent discrepancies and continually improve our programs.”

In the report, the inspector general’s office acknowledged Carolinas HealthCare disputes some of the findings, but the office said it maintains that the hospitals incorrectly billed Medicare.

  • Local NewsMore>>

  • Victims and gunmen identified in fatal shooting at a Union Co. hotel

    Victims and gunmen identified in fatal shooting at a Union Co. hotel

    Sunday, April 22 2018 5:36 PM EDT2018-04-22 21:36:51 GMT
    (Fred Craft | WBTV)(Fred Craft | WBTV)

    Officials are conducting a homicide investigation after Union County police found one person dead and three others injured at a hotel. According to a report, officials say they responded to the Relax Inn on U.S. 74 around 1 a.m. Sunday morning when they located the victims of a shooting.  

    More >>

    Officials are conducting a homicide investigation after Union County police found one person dead and three others injured at a hotel. According to a report, officials say they responded to the Relax Inn on U.S. 74 around 1 a.m. Sunday morning when they located the victims of a shooting.  

    More >>
  • Councilwoman LaWana Mayfield apologizes for 'the hurt that may have been caused' from 9-11 conspiracy Facebook post

    Councilwoman LaWana Mayfield apologizes for 'the hurt that may have been caused' from 9-11 conspiracy Facebook post

    Sunday, April 22 2018 5:34 PM EDT2018-04-22 21:34:31 GMT
    Charlotte City Council member LaWana Mayfield questioned whether the 9-11 terrorist attacks were real in a social media post Monday, saying she is "still waiting for someone to produce pieces of the alleged plane." (Charlotte Observer File Photo)Charlotte City Council member LaWana Mayfield questioned whether the 9-11 terrorist attacks were real in a social media post Monday, saying she is "still waiting for someone to produce pieces of the alleged plane." (Charlotte Observer File Photo)

    Charlotte City councilwoman LaWana Mayfield said on Sunday that she is not going to resign following requests for such about a post she created on Facebook questioning the authenticity of the 9-11 attacks in New York City.  

    More >>

    Charlotte City councilwoman LaWana Mayfield said on Sunday that she is not going to resign following requests for such about a post she created on Facebook questioning the authenticity of the 9-11 attacks in New York City.  

    More >>
  • FIRST ALERT: Heavy rain expected in the beginning of the week

    FIRST ALERT: Heavy rain expected in the beginning of the week

    Sunday, April 22 2018 9:56 AM EDT2018-04-22 13:56:01 GMT

    We are getting a clearer picture now on the timing and arrival of rain for our First Alert Days Monday and Tuesday. We want to emphasize there is no severe weather threat this week, but just don't want anybody to get caught off guard by the heavy rain after such a beautiful weekend.  

    More >>

    We are getting a clearer picture now on the timing and arrival of rain for our First Alert Days Monday and Tuesday. We want to emphasize there is no severe weather threat this week, but just don't want anybody to get caught off guard by the heavy rain after such a beautiful weekend.  

    More >>
Powered by Frankly