It was just on our local nightly news that one of the largest hospitals in the country, one of two large hospitals in our part of the state, is caught up in the CMS (medicare) investigation of overbilling by improper classification of patients as in patient instead of out partient. Billing for 218 patients from 2010-2011 is said to be responsible for improper over charges equaling more than one and a half million dollars.
CMS wants their money back and the hospital says they will look to the patients to pay the difference owed. The problem arose because the hospital classified the patient as an inpatient receiving treatment and medicare says the patient was merely under observation and should have been charged as an outpatient. The few families interviewed who might be affected are confused and upset. After three years no one expected something like this to become a problem.
At the very least the patient should be informed of their status and understand their financial responsibilities at the time of hospitalization.
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