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Audit (A-05-09-00010)

05-27-2009
Review of Oxaliplatin Claims Processed by National Government Services for Calendar Years 2004 and 2005

Executive Summary

For all 88 payments reviewed, 10 hospitals billed National Government Services for the incorrect number of service units of oxaliplatin. As a result, the hospitals received overpayments totaling $2.2 million during calendar years 2004 and 2005. These overpayments occurred primarily because the hospitals did not update their systems following a change in Medicare billing guidance.

We recommended that National Government Services recover the $2.2 million in overpayments to hospitals. In written comments on our draft report, National Government Services agreed with our finding and recommendation and said that it had recouped all of the outstanding provider overpayments.

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