Three prominent medical centers must repay Medicare's organ-acquisition program $4.6 million combined if they cannot justify certain expenses for organ transplants, HHS said.
Agency audits identified $793,500 in overcharges at Yale-New Haven (Conn.) Hospital from 1998 to 2001; $2.5 million in overcharges at University of California-Los Angeles Medical Center in 1999; and $1.3 million in overcharges at St. Vincent Medical Center, Los Angeles, in 1999.
HHS said some of the claims were "unallowable" because they did not meet Medicare's definition of organ acquisition or were incurred for non-Medicare-certified transplant programs. Some of the claims were "unsupported" because they were not adequately documented.
Medicare's organ-acquisition program pays for pretransplant services only. Surgeries and post-transplant care are reimbursed differently. The claims involved heart, kidney, liver and pancreas transplant services.