Status Report - Office of Inspector General/Department of Justice Joint Project--Medicare Nonphysician Outpatient Bills Submitted by Hospitals

EXECUTIVE SUMMARY:

This report provides the status of an ongoing nationwide project being conducted jointly by the Office of Inspector General and the Department of Justice. The primary objective of the project is to recover from hospitals improper amounts billed for nonphysician outpatient services that were also included in inpatient payments made under Medicare's prospective payment system (PPS). To date the project has identified 4,660 hospitals that submitted bills for outpatient services included in inpatient payments made under the PPS. The Project Team estimates that the project will result in recoveries of about $100 million from the hospitals, refunds to beneficiaries, and improved hospital controls.