Costly Medicare Hospital Stays Earn Watchdog’s Skepticism

Feb. 24, 2021, 11:15 PM

A government watchdog agency wants Medicare to conduct targeted reviews of high-severity hospital stays and the facilities that bill for them after finding these most-costly hospitalizations have increased nearly 20% over a five-year span and now account for nearly half of all program spending for hospital stays.

“Oversight is essential to ensuring that Medicare dollars are spent appropriately. Inpatient hospital billing in the years leading up to the pandemic indicates that some stays at the highest severity level could be susceptible to” upcoding, or inappropriately billing for services at a higher-than-warranted severity level, the Department of Health and Human Services’...

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