Friday, February 27, 2015

Baptist Health North Little Rock to pay $2.7 million for improper Medicare claims

Posted By on Fri, Feb 27, 2015 at 4:44 PM

BAPTIST HEALTH NORTH LITTLE ROCK
  • BAPTIST HEALTH NORTH LITTLE ROCK
Baptist Health Medical Center North Little Rock has agreed to pay $2.7 million to settle a federal finding that it had submitted improper claims to Medicare for short stays at the 248-bed hospital in 2008 and 2009.

U.S. Attorney Chris Thyer announced the agreement on behalf of the Office of Inspector General of the Department of Health and Human Services. 

The government said the agreement covered payments the hospital sought from Medicare between Jan. 1, 2008 and Dec. 31, 2009. A government news release said these covered "short stay" inpatient "encounters" of less than two nights. It said the hospital submitted claims as a result of "a) improper orders for inpatient status converted from outpatient status; b) improper inpatient standing orders for admission without proper involvement of a physician, and c) improper orders for inpatient status following scheduled outpatient procedures."

Thyer's release said that, in return for release of exclusion liability under the Social Security Act, the hospital agreed to enter a five-year integrity agreement that requires it and a sister hospital in Little Rock to be subject to independent annual claims reviews.

The inspector general's audit had been referred to the Justice Department.

I have put in a call to Baptist Health, which operates the hospitals and others, for comment.

UPDATE FROM BAPTIST HEALTH:

Following a 2011 routine Medicare billing audit of seven Medicare claims areas for the years 2008 and 2009 at our medical center in North Little Rock, the Office of the Inspector General for HHS identified possible errors in only one of the seven areas identified.

These disputed claims amount to approximately 550 claims or less than seven tenths of 1% of the total claims submitted to the federal government by the North Little Rock facility during that time period. Specifically, these were claims centered around the federal government’s reimbursement regulations for the decision about whether to admit an individual for hospital inpatient care or to provide observation services .

In settling this matter, Baptist Health is not admitting any liability and the federal government has not alleged any issues with patient care or patient safety or quality of care. To avoid the inconvenience and expense of a protracted dispute with the federal government, we have agreed to settle by paying overpayments received in 2008 and 2009. We have also agreed to work with the federal government to monitor our admissions policies and build on our existing and comprehensive compliance program of robust training, reporting and review protocols.

As of October of 2014, the office of Inspector General has suspended reviews of the same type of short stay claims. National health care groups have advocated changes in policy surrounding reimbursement relating to short hospital inpatient admissions. They claim the shifting and often ambiguous standards make it extremely difficult for physicians and hospitals to consistently comply with the regulations.

In fact, the American Hospital Association has filed lawsuits, which we support, challenging the U.S. Department of Health and Human Services regulatory rules surrounding inpatient admissions. The AHA has contended the regulations impose burdens that could compromise care for seniors and represent unlawful arbitrary standards and documentation requirements while depriving hospitals of proper Medicare reimbursement for caring for patients.

"In resolving this audit settlement Baptist Health will continue to demonstrate daily the highest ethical standards, as we strive to operate in a complex and changing regulatory environment." said Mark Lowman, Spokesman for Baptist Health.
Favorite

Comments (7)

Showing 1-7 of 7

Add a comment

 
Subscribe to this thread:
Showing 1-7 of 7

Add a comment

More by Max Brantley

Readers also liked…

  • Monticello preparing for KKK rally

    Drew County authorities are taking precautions, but also watching their words, about apparent plans for a Ku Klux Klan meeting Saturday.
    • Jul 22, 2015
  • AHTD asks Metroplan to lift six-lane freeway cap

    The board of directors of Metroplan has informed the state highway department that it cannot act on the highway department's June 17 request to lift its six-lane freeway cap at the board's June 29 meeting. Consideration of the request should take four months, Jacksonville Mayor Gary Fletcher wrote June 22 to highway department Director Scott Bennett.
    • Jun 23, 2016
  • Rutledge refuses open records of fired trooper who now leads ABC enforcement

    Attorney General Leslie Rutledge yesterday refused to allow release of records that explain the 2000 firing of Boyce Hamlet as a state trooper.
    • Sep 1, 2015

Most Shared

  • World leaders set to meet in Little Rock on resource access and sustainable development

    Little Rock will next week host a series of meetings on the use of technology to tackle global problems led by Club de Madrid — a coalition of more than 100 former democratic former presidents and prime ministers from around the world — and the P80 Group, a coalition of large public pension and sovereign wealth funds founded by Prince Charles to combat climate change.
  • Rapert compares Bill Clinton to Orval Faubus

    Sen. Jason Rapert (R-Conway)  was on "Capitol View" on KARK, Channel 4, this morning, and among other things that will likely inspire you to yell at your computer screen, he said he expects someone in the legislature to file a bill to do ... something about changing the name of the Bill and Hillary Clinton National Airport.

Visit Arkansas

View Trumpeter Swans in Heber Springs

View Trumpeter Swans in Heber Springs

Magness Lake, in Heber Springs, is a magnet for swans

Most Recent Comments

Blogroll

 

© 2016 Arkansas Times | 201 East Markham, Suite 200, Little Rock, AR 72201
Powered by Foundation