U.S. Department of Health and Human Services Office of the Inspector General

The Office of the Inspector General of the U.S. Department of Health and Human Services has “…observed significant vulnerabilities in the [Medicare area] wage index system…”  As a result of these vulnerabilities, Medicare has overpaid 272 hospitals by more than $140 million over the past 13 years. The vulnerabilities the OIG identified that contributed to these overpayments are: absent misrepresentation or falsification, CMS lacks the authority to penalize hospitals that submit inaccurate or incomplete wage data; Medicare Administrative Contractors’ limited reviews do not always identify inaccurate wage data; the rural floor decreases wage index accuracy; and hold-harmless provisions in federal [...]