The federal government paid $20 million too much for ambulance trips tied to skilled nursing stays, according to the Office of the Inspector General.
The agency shared the results of a recent investigation on Monday. It found that significant overpayments for these trips have continued, even after it called them out previously.
OIG has determined that Medicare made Part B payments to ambulance suppliers for transportation services that were also included in Medicare Part A allotments to SNFs. The agency made its determination by studying a sample of claims tallied between July 2014 and June 2016.
For 78 of the 100 beneficiary days sampled, Medicare made Part B payments that were incorrect. It estimated that on the basis of that sample, Medicare made a total of $19.9 million in Part B overpayments to ambulance suppliers for Part A SNF stays. Beneficiaries also incurred an estimated $5.2 million in coinsurance and deductible liabilities tied to those incorrect payments, the office said.
OIG is urging the Center for Medicare & Medicaid Services to correct its “common working file” to prevent future overpayments, and to recover the incorrectly billed claims. According to the office, file edits were not designed to prevent or detect Part B overpayments, and ambulance suppliers did not have the necessary controls to prevent such improper billing.
CMS officials have concurred with those recommendations and are taking steps to implement them, according to the announcement.
