Feinberg teaching hospital owes Medicare $6.4 million, federal report says

Madeline Fox, Assistant Campus Editor

A recent federal audit found Northwestern Memorial Hospital owes Medicare an estimated $6.4 million for alleged billing errors.

A report from the U.S. Department of Health and Human Services’ Office of Inspector General says the primary teaching hospital for the Feinberg School of Medicine incorrectly billed Medicare. The report, released earlier this month, says the hospital charged Medicare Part A, which handles inpatient stays, for visits that should have been billed as outpatient services.

Of the 171 cases reviewed, the audit found that 85 did not fully comply with Medicare billing requirements, resulting in an estimated $6.4 million discrepancy overall.

Northwestern Medicine, the hospital’s parent company, said it will appeal decisions on 28 of the 85 cases federal auditors said were improperly billed.

“It is our belief that OIG’s claims review process and statistical methodologies are flawed, resulting in a grossly overstated repayment amount,” Kris Lathan, director of public relations for the hospital, said in a statement after the report’s release.

Federal officials gave the Chicago hospital an opportunity to respond to the initial findings in January before making the report public. The hospital said the audit’s calculations ignore the money the hospital is entitled to under Medicare Part B, which covers outpatient services.

In response to the initial findings, National Government Services, a Medicare contractor, sent the hospital a letter demanding it repay the nearly $6.4 million in overcharges identified by the federal audit.

Federal auditors stood by its recommendations following Northwestern Medicine’s response.

“After considering the hospital’s comments, we continue to recommend that the hospital refund to the Medicare contractor $6,389,095 in estimated overpayments and strengthen controls to ensure full compliance with Medicare requirements,” the report said.

The audit was one of a series of reports conducted to review hospital compliance with Medicare billing requirements.

Email: mfox17@u.northwestern.edu
Twitter: @MadelineFox14

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