DATE: Saturday, July 5, 1997                TAG: 9707050087

SECTION: LOCAL                   PAGE: B1   EDITION: NORTH CAROLINA 

SOURCE: JEFFREY S. HAMPTON, STAFF WRITER 

DATELINE: ELIZABETH CITY                    LENGTH:   45 lines

HOSPITALS REPAY U.S. FOR OVERBILLING ALBEMARLE AND CHOWAN ARE AMONG 34 HOSPITALS IN THE REGION THAT MADE ERRORS IN MEDICARE BILLING.

Albemarle Hospital and Chowan Hospital are among 34 medical facilities in eastern North Carolina that were forced to repay the federal government for overbilling Medicare charges.

Saying the charges were very small, hospital directors are miffed at the government's well-circulated news releases that present hospitals as villains.

``It wasn't an issue of fraud,'' said Phil Bagby, president and CEO of Albemarle Hospital.``Most hospitals could not get their billing system changed quick enough to abide by the rules. The amounts were less than one tenth of 1 percent of the total Medicare billings''

According to the release from the U.S. Attorney's office, Medicare regulations require hospitals to bill the government a flat fee for inpatient services and any outpatient services rendered within three days of the hospital admission.

The hospitals in violation billed Medicare for the inpatient service and then separately for the related outpatient service.

``The government does not allege the hospitals were intentionally double billing,'' said Norman Acker, assistant U.S. Attorney for the Eastern District of North Carolina. ``What we are saying is that after three audits, they should have corrected their billing practices.''

The government changed the Medicare billing procedure in the mid 1980s. Between 1987 and 1992, the government conducted four audits of hospitals to be sure they complied and found many of the facilities were not following the rules.

After each of the first three audits, the government reclaimed the exact amount the hospitals overcharged, Acker said. After the fourth audit, the government got tougher and began handing out penalties.

Albemarle Hospital paid $13,585 and Chowan Hospital paid $2,246. Both fees are below the average in penalties. Wake Medical Center in Raleigh paid $64,281. The overbilling occurred in hospitals nationwide.

Acker's office, under the jurisdiction of U.S. Attorney Janice Cole, began trying to collect the overcharges with interest and penalties in August 1996. The total has reached $856,095 in this district.

Nationwide, the government has collected about $45 million, according to the release.

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