Beth Israel Deaconess Medical Center will pay more than $5 million to settle allegations that the teaching hospital made improper Medicare claims.
From mid-2004 to mid-2008, the U.S. Attorney?s Office said, the hospital improperly filed claims for inpatient admissions for patients who stayed overnight with congestive heart failure, chest pain and other ailments. The procedures should have been billed as observational services, which is an outpatient service, according to U.S. Attorney Carmen Ortiz?s office.
Medicare reimbursements to hospitals are significantly higher for inpatient admissions.
Under the agreement, the hospital does not admit any fault or wrongdoing but will pay $5.315 million to settle the allegations that it violated the False Claims Act.
?When hospitals unnecessarily admit Medicare patients for short inpatient stays when the appropriate treatment would be outpatient or observation care, they improperly boost hospital profits at significant expense to taxpayers and patients,? said Susan J. Waddell, special agent in charge of the Department of Health & Human Services, Office of Inspector General.
In a statement, the hospital called the distinction ?an extremely technical issue? that challenges hospitals around the country.
The hospital has already taken steps to address the issue, according to the statement, including enhancements to the billing classification system and creating a new position in charge of compliance.
?BIDMC is committed to delivering the appropriate level of care to patients in need and ensuring that the hospital is in full compliance with all applicable rules and regulations,? the statement said.
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