EL CENTRO, Calif. – September 20, 2010 – ECRMC announced today that it has paid approximately $2.2 million in Medicare over billings.
The hospital was notified of an investigation, starting in mid-2007, brought forth by a former employee. The suit alleged that Medicare billings for inpatient care short stays should have been classified as outpatient services. ECRMC has been cooperating with investigators since approached. After thorough investigations only isolated Medicare billing issues have been identified. Not all Medicare billings were affected and patient and private insurance billings were not affected.
The majority of the instances, occurred from 2000 to 2003 and no allegations were made with respect to the Hospital’s quality of care, the issue was due to incorrect service designation between inpatient and outpatient observation services. All patients were given their needed medical care. Patients seeking both inpatient care and outpatient care received the highest quality of medical care available locally and ECRMC remains committed to being a ‘Community of Care.’
“It is an unfortunate error in reporting,” said David Green, CEO of ECRMC. “This was an unintentional mistake that has been identified and rectified. The issue is a very complicated procedure for proper designation and has been problematic for many hospitals nationwide.”
The hospital continues to take its Medicare billing obligation very seriously and remains committed to compliance with all laws, regulations and guidance relating to its participation in Medicare and other healthcare programs. This settlement has not affected the provider status of ECRMC as a Medicare provider.
“This settlement is a business decision by the Hospital, as approved by the Board of Directors,” said Green. “It was determined that this is in the best interest of all involved including the hospital, its employees and the community to resolve this issue and move forward with our mission to provide healthcare excellence to the community.”
The hospital has implemented several changes to its utilization review management, coding documentation and billing processes in order to more accurately document the assignment of patient status. “Although these cases are not recent, and this issue is far more widespread than just our local hospital, we take this situation very seriously and are taking the necessary steps to ensure it doesn’t happen again,” said Green.
“ECRMC has and will continue to provide the best health care available in the region,” added Green. “The hospital is instituting state-of-the-art tracking systems and modern procedures, which will help to avoid paperwork errors such as this in the future.”
El Centro Regional Medical Center (ECRMC) is a licensed 165-bed general acute care facility located in El Centro, Calif. ECRMC is committed to providing the community with high quality healthcare as reflected in its mission statement: “To Provide Healthcare Excellence For The Imperial Valley.”
ECRMC is moving forward with the planning and development of the hospital expansion project that will replace the older portion of the hospital. In addition, the hospital is developing a state-of-the-art facility to meet the needs of the Imperial Valley and provide an advanced healthcare facility and service, helping ECRMC continue to achieve it’s goal of providing excellence in healthcare.
Recent additions to the hospital include the opening of the Wound Care Center; the implementation of the Hospitalist Program; the Asthma and Diabetes Program; and the Children’s Specialist Program. A new Outpatient Center is planned in order to continue excellent service within the local community.
ECRMC has also recently announced a collaboration with the Oncology and Hematology Center of Imperial Valley to create the El Centro Regional Medical Center Oncology and Hematology Center. Maintaining its commitment to medical technology advancement, the hospital has invested in the da Vinci Si HD Surgical System. The surgery system allows for safe and less intrusive procedures in various surgical fields, including urology, cardiology, obstetrics/gynecology and more.