Maury Regional Medical Center (MRMC) has reached an agreement with federal officials regarding self-disclosed billing errors that resulted in Medicare overpayments from 2013-2019, officials have announced.
“This settlement is based on the findings of our own internal review, during which we engaged the expertise of an independent auditor. After identifying errors through this audit, we accepted the responsibility to self-report our documentation concerns to the government,” said CEO Alan Watson.
The overpayment resulted from insufficient documentation to support MRMC’s billing in the areas of stroke, respiratory failure, pneumonia and septicemia. As part of the settlement, MRMC will repay approximately $1.7 million. According to Watson, the medical center has been setting aside funds since first learning of this matter and initiating the self-disclosure process. The government has agreed to allow the organization to make repayment over a two-year period.
“We take our responsibility to accurately document and bill very seriously. Since discovering the concerns, we have worked closely with government officials to fully correct this issue and ensure that our current billing practices meet all regulations,” Watson said.
To address these findings, MRMC officials state that they have developed a more robust pre-bill review process and conducted extensive education with staff. In addition, a member of the compliance team has attained additional certification in coding documentation and will be performing ongoing reviews for accuracy as well as engage independent auditors for periodic third-party reviews.
“While it is unfortunate that this occurred, I am proud that our organization took immediate responsibility to self-report and quickly instituted measures to ensure this does not happen again. I am confident that our billing practices are now fully compliant with all regulations,” said Watson.