OIG Sounds Alarm On Medicare's Hospital Outlier Payments

Law360, New York (November 15, 2013, 7:16 PM EST) -- A small fraction of the nation’s hospitals have accounted for a big portion of Medicare’s extra spending on extraordinarily costly patients, raising questions about billing practices as well as potential flaws in reimbursement formulas, according to an inspector general’s report Thursday.

The study found that 158 of 3,200 hospitals surveyed were responsible for one-quarter of so-called outlier payments that compensate hospitals for unusually expensive inpatient visits. From 2008 to 2011, the small group of hospitals collectively received $4 billion in outlier money, while the much larger...
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