News that Medicare improperly paid about $33 million for healthcare services to thousands of incarcerated patients between 2009 and 2011 should motivate hospital leaders to strengthen or establish relationships with local law enforcement authorities, a healthcare billing and legal expert says.
The Office of Inspector General announced this month that the Centers for Medicare & Medicaid Services made Medicare payments totaling $33.6 million to healthcare providers for services to approximately 11,600 incarcerated beneficiaries during calendar years 2009 through 2011.
CMS did not have policies and procedures that would have enabled it to detect such improper payments after the payments were made, OIG reported; nor did it notify its payment processing contractors to recoup any such payments.
CMS in April plans to implement a process for detecting and recouping improper payments for previously paid Medicare claims, according to the OIG.
While CMS is revisiting its policies, healthcare leaders should, too. Even if a hospital is not part of this particular recoupment process, it's a good time to review policies and procedures regarding incarcerated patients and even consider contracting with local law enforcement authorities regarding such patients.