Healthcare News & Insights

Hospital settles Medicare overcharge allegations

A dispute over what constitutes a “complicated” cardiac procedure has cost an Iowa hospital roughly $1.4 million.

Mercy Medical Center-Sioux City agreed to pay $400K to settle allegations by the U.S. Attorney General that it wrongly charged Medicare for cardiac care. The feds claim the hospital abused the “outlier” program in which Medicare pays more to providers who take on more complicated procedures.

Mercy denied all wrongdoing and spent approximately $1M on legal fees to defend the charges.

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