• The Office of Inspector General ("OIG") Issues a Review of Allowable Medicare Capital Disproportionate Share Hospital ("DSH") Payments for the Period October 1, 2000, Through September 30, 2006
  • December 22, 2008 | Authors: Joseph V. (Joe) Geraci; Mia C. Garcia
  • Law Firms: Brown McCarroll, L.L.P. - Austin Office ; Brown McCarroll, L.L.P. - Houston Office
  • On November 7, 2008, the OIG released an audit report of its review of Medicare capital DSH payments for the period October 1, 2000, through September 30, 2006. The OIG found that of the 2,396 acute care hospitals that claimed $1.62 billion in capital DSH payments on submitted cost reports, 397 hospitals in rural areas with fewer than 100 beds claimed $21.9 million in unallowable capital DSH payments. The OIG recommends that CMS do the following:

    • Direct fiscal intermediaries to recover the $21.9 million in capital DSH payments;
    • Determine whether capital DSH payments were made to ineligible hospitals for the period subsequent to the end of the OIG’s review and direct fiscal intermediaries to recover any unallowable payments; and
    • Conduct reviews on a recurring basis to determine whether capital DSH payments are being made to ineligible hospitals.

    CMS agreed with the OIG’s recommendations.