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HHS OIG: Medicare Did Not Pay Selected Inpatient Claims for Bone Marrow and Stem Cell Transplant Procedures in Accordance With Medicare Requirements

February 1, 2016

Pursuit's Take

Medicare did not pay selected inpatient claims for bone marrow and stem cell transplant procedures in accordance with Medicare requirements, resulting in overpayments of $6.3 million over more than 31⁄2 years.

Medicare paid 10 of 143 selected inpatient claims for bone marrow and stem cell transplant procedures in accordance with Medicare requirements. However, 133 claims did not comply with those requirements. As a result of the 133 errors, Medicare overpaid the hospitals by $6.3 million. Medicare overpaid the hospitals because existing controls were not effective in preventing the overpayments.

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