OIG requests $10.2 million in overpayment refunds from Rush University Medical Center

Rush University Medical Center in Chicago did not comply with Medicare billing requirements for 57 inpatient and outpatient claims reviewed by the OIG, according to the OIG’s November report. This resulted in unlawful reimbursement for calendar years 2014 and 2015 with the medical center receiving $814,150 in overpayments, says the report.

Out of the 120 claims reviewed by OIG, 51 inpatient claims and six outpatient claims reportedly have billing errors. The majority of the overpayments were due to inpatient claims errors and were caused by a lack of controls to protect risk areas, according to the report.

In total, the OIG says these overpayments add up to an estimated $10.2 million in overpayments per audit period, $814,150 of which were the overpayments identified in the OIG’s sample. The OIG is requesting that Rush University Medical Center refund the total sum to the Medicare contractor, strengthen their controls to be up to date with Medicare compliance requirements, and identify any returned overpayments.