Texas hospital repays nearly $1M in Medicare reimbursements

The Ben Taub General Hospital in Houston has repaid Medicare nearly $1 million after auditors found it improperly billed the government for outpatient dental services, according to a houstonchronicle.com story.

In February, the U.S. Department of Health and Human Services (HHS) issued a report concluding that the hospital improperly received $819,000 in Medicare reimbursements for hospital outpatient dental services provided from January 2010, through December 2011.

During the two-year period, Ben Taub received the second-most reimbursements among all Texas hospitals for Medicare services that were deemed ineligible for such payments, the HHS said.

Medicare generally does not cover hospital outpatient dental services. To be covered, the procedures must be performed as part of a diagnosis related to cancer or physical trauma, HHS said.

On most claims, the hospital billed Medicare for extractions that were typically performed as a result of caries, which is not a covered procedure. The hospital also wrongly billed for tooth socket repairs (e.g., reshaping of the tooth bone), which is also excluded from Medicare coverage.