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BRH to Repay Nearly $1 Million in Medicare and Medicaid Billing Errors

By | November 27, 2012

Bartlett Regional Hospital must repay the state and federal governments close to a million dollars for six years of Medicare and Medicaid billing errors. The hospital also may have to pay penalties for the errors, which violated federal law.

In a memo to the Bartlett Board of Directors Monday, Hospital Attorney Richard Monkman said Bartlett’s Patient Financial Services Director reported in April that some Emergency Department charges were being submitted to Medicare and Medicaid under incorrect provider names. That’s because a number of Emergency Room providers were not properly enrolled in Medicare and Medicaid. So, in order to bill for those services, hospital staff submitted billings under the name of an enrolled physician.

In addition, some non-physician services were billed to the programs at the physician billing rate without proof that a doctor had seen the patient.

Monkman said the incorrect billing practices have stopped, and an investigation and audit were performed at the direction of the hospital board. The reviews did not find any intent to defraud or misappropriation of funds. All services were provided by licensed, credentialed health care providers.

The amounts to be repaid total $648,227 in Medicare and $308,216 in Medicaid billings. That’s about 0.02 percent of the hospital’s Medicare and Medicaid billings from 2006 through 2012.

Monkman says the standard federal penalty in such cases is 1.5 times the amount of the billing error.

Hospital Spokesman Jim Strader says Bartlett already has the funds on hand, and it will not result in price hikes or funding requests to the Juneau Assembly.

The hospital board is expected to discuss the matter at its regular meeting on Tuesday.

Bartlett Regional Hospital is a City and Borough of Juneau enterprise fund. Its board of directors is appointed by the CBJ Assembly.

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