Medicare May Have Overpaid $17.8 Million for Opioid Use Disorder Treatment Services
9/30/2023
On August, 17, 2023, the U.S. Department of Health and Human Services Office of Inspector General (OIG) found that payments made to opioid treatment programs (OTPs) for opioid use disorder (OUD) treatment services may not have complied with Medicare requirements. Specifically, Medicare made potentially improper payments totaling $17.8 million to OTPs. This consisted of the following:
• $10.4 million for claims where bundled payments were made for a weekly episode of care covered by another weekly bundle for the same care at the same OTP.
• $5.1 million for take-home supplies of medication covered by other payments or bundled payments.
• $1.3 million for OUD treatment services claimed without a proper OUD diagnosis.
• $1 million for intake activities that occurred excessively for the same patient.
Related Practices: Healthcare Law
Related Attorney: Carol Grelecki, Edward J. Yun
Related Industry: Healthcare