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Hospitals get Medicare funds in billing dispute

Twelve area hospitals received a total of $1.79 million from the federal government to resolve a Medicare billing dispute, according to the federal Centers for Medicare and Medicaid Services.

The money paid to the Western New York hospitals comes as part of $1.5 billion provided to 2,022 hospitals across the country to settle 346,000 Medicare claims for patients treated on or before Oct. 1, 2013.

The settlements resolve long-standing disagreements over how much the hospitals say they were owed.

The federal government agreed to pay 68 percent of the value of the claims that had languished in Medicare’s hearings and appeals process, according to Kaiser Health News.

Kaiser Health News filed a Freedom of Information Act request for the settlement payment data.

The federal government uses private contractors to review hospital claims for improper payments.

Hospital industry officials say the private contractors have a financial motive to flag more claims because they are paid for each improper claim.

In this region, the biggest payments – $319,562 – went to Kaleida Health to settle 43 claims at its hospitals. Jones Memorial Hospital in Wellsville received $24,643 – the smallest amount – to settle 10 claims.

Eastern Niagara Health System in Lockport, which received $270,364, settled the highest number of claims, 110. In total, the 12 hospitals in the region settled 544 claims.


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