Medicare Hospital Payment Appeals Skyrocketing, OIG Finds

Law360, New York (October 4, 2013, 7:39 PM EDT) -- Hospital appeals of rejected Medicare reimbursements have surged in recent years amid expanded use of auditors to spot overpayments, but they’ve typically been unsuccessful, according to an inspector general’s report Wednesday.

The analysis looked at the so-called redeterminations that represent the first of five levels of appellate review, and found that Medicare Part A appeals soared by about 150 percent over the past five years, to about 650,000 in 2012 from roughly 260,000 in 2008.

That spike was attributed mainly to the introduction of so-called recovery...
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