OIG says N.Y. hospital owes $14.2 million in Medicare overpayments

An HHS audit of inpatient and outpatient claims made by New York-Presbyterian Hospital concluded the mammoth hospital on Manhattan’s Upper West Side may have received more than $14.2 million in Medicare overpayments. The audit also blasted New York-Presbyterian for its inadequate Medicare billing controls.

New York-Presbyterian disputed the Office of Inspector General’s findings, telling the watchdog its review misapplied Medicare requirements. The $14.2 million overpayment estimate was “improper and statistically unsound,” the system said in a statement.

The OIG audit looked at 285 claims in calendar years 2011 and 2012 and found that 123 did not fully comply with Medicare billing requirements, others were incorrectly billed and still others were billed more than once.

The New York hospital, which is a main teaching hospital for the Columbia University College of Physicians and Surgeons, agreed 32 of the audited claims resulted in incorrect billings and disputed the others.

New York-Presbyterian also maintained that the vast majority of the highlighted payments could no longer be recouped by CMS since the statute of limitations had expired.

The hospital received $1.5 billion in Medicare payments during calendar years 2011 and 2012, according to the HHS OIG audit.