State Auditors Find Medical Billing Regulatory Oversight Lacking

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An audit conducted by the Maryland legislature has found that the state’s regulatory bodies charged with keeping tabs on hospital billing were not doing an adequate job of ensuring uniform medical billing, costing the state as much as $13 million.

The audit focused on three regulatory agencies under the state’s Department of Health and Mental Hygiene. One agency – the Health Services Cost Review Commission – was singled out for “control deficiencies” leading the auditors to conclude that they could not be confident billing at the state’s 53 hospitals was proper.

Auditors said that the HSCR Commission did regularly find overbilling in its reviews of hospitals, but did not follow up on fixes. The auditors said they found overcharges ranging from 67 percent to 1,880 percent higher than allowed under state rules, some dating to 2001.

The overbilling was confined to four hospitals in the state, but the auditors did not publicly disclose which ones.

 

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Posted in Denials Management, Medical Receivables, Patient Financial Services .

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