Penn State Health submitted claims to Medicare Part B for E&M services that were not supported by the medical record on the same date of service as infusion services, according to U.S. Attorney Gerard M. Karam, After it discovered the problems, Karam said that Penn State Health took prompt corrective action.
has agreed to pay more than $1.2 million to resolve allegations of civil liability for submitting claims to Medicare for Evaluation & Management services that violated Medicare rules and regulations, the United States Attorney’s Office for the Middle District of Pennsylvania announced on Tuesday.
According to U.S. Attorney Gerard M. Karam, Penn State Health voluntarily disclosed that between January 2015 and March 2019 for the Hershey Medical Center in Derry Township, and between July 2015 and June 2018 for St. Joseph Medical Center in Bern Township, Berks County, Penn State Health submitted claims to Medicare Part B for E&M services that were not supported by the medical record on the same date of service as infusion services.
“Once the billing error was identified, we immediately took measures to correct our billing. We self-reported the error to the United States Attorney’s Office, fully cooperated with the government during its review and repaid the amounts to Medicare and other federal health care payers, so the matter is now settled. We have taken steps to prevent this from happening in the future.”
This matter was handled by the Department of Health and Human Services, Office of Counsel to the Inspector General, and Assistant U.S. Attorney Tamara Haken of the Affirmative Civil Enforcement Unit of the U.S. Attorney’s Office for the Middle District of Pennsylvania.
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