Medicare paid $1.5 billion in improper therapy claims in 2009

By Chad TerhuneNovember 13, 2012, 10:48 a.m.

 Medicare paid $1.5 billion in improper claims for skilled nursing care in 2009, federal investigators found.

The inspector general of the Department of Health and Human Services said Tuesday that 25% of all Medicare claims submitted by skilled nursing facilities had errors and the majority of those bills were “upcoded” for ultra-high therapy that wasn’t necessary.

About 15,000 nursing homes and other facilities provide this physical therapy, rehabilitation and other care to patients, often after a hospital stay. Medicare generally covers these services for up to 100 days related to an illness.

The inspector general’s office urged Medicare to increase its scrutiny of these skilled-nursing claims, particularly in light of previous reports identifying billing problems in this area.

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