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Government Cites $20 Million in Overpayments in Medicare Outpatient Radiology Billing

by Barbara Kram, Editor | September 19, 2006
Government accountants found Medicare
was double billed for radiology
The Department of Health and Human Services Office of Inspector General (OIG) has audited Medicare payments for radiology and found some troubling results. The audit focused on beneficiaries during inpatient stays at hospitals along with outpatient radiology services provided to those inpatients.

"Rather than billing the hospitals for these services, radiology suppliers billed the carriers and received separate payments," the report concluded. As a result, OIG reports that Medicare may have overpaid due to paying twice--both to the hospital and to the radiologist.

The government auditors recommend that Medicare carriers recover $20 million in potential overpayments identified in the review. Other recommendations are to monitor the recovery of those overpayments, and establish prepayment controls or postpayment reviews to detect and prevent the problem of separate payments for Medicare Part B radiology services provided to beneficiaries during inpatient stays. Another recommendation is to alert Medicare carriers to the most common types of payment errors and help them educate radiology suppliers about such improper billings.
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Read more about it at
http://www.oig.hhs.gov/oas/reports/region1/10400528.htm