WakeMed To Pay $8M For Medicare Billing Misconduct

Law360, New York (December 20, 2012, 6:04 PM EST) -- Raleigh, N.C.-based WakeMed Health & Hospitals will pay $8 million to resolve allegations it overbilled Medicare by wrongly classifying outpatient procedures as inpatient services that qualified for greater reimbursement, the U.S. Department of Justice said Thursday.

The misconduct spanned several years and led to health care system WakeMed being identified as having the state’s largest percentage of so-called zero-day stays, in which claims are submitted for inpatient stays despite patients not remaining in the hospital for even one night, the DOJ said. Investigators ultimately determined that instead of relying on physician orders, WakeMed admitted patients based on a list of procedures...

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