Two Pennsylvania hospitals have agreed to pay a total of $1.6 million to settle allegations that they manipulated codes for pneumonia diagnoses to reap higher Medicare payments.
They are the third and fourth hospitals nationally to settle charges as part of the government's ongoing investigation into how hospitals bill Medicare for pneumonia diagnoses. At issue is whether hospitals billed Medicare for higher-paying bacterial pneumonia when patients were suffering from lower-paying viral pneumonia.
Easton (Pa.) Hospital will pay $1.1 million to settle charges that it wrongly billed Medicare from October 1992 to March 1997. Philadelphia's Presbyterian Medical Center, part of the University of Pennsylvania Health System, will pay $535,000 to settle charges that it misbilled Medicare over the same five-year period.
Both 273-bed Easton and 325-bed Presbyterian denied any wrongdoing and cooperated in the investigation.