Becker's Hospital Review

12 CFO / FINANCE Illinois, Texas hospitals mistakenly billed patients for COVID-19 vaccines By Alia Paavola H ospitals in Illinois and Texas mistakenly billed some patients for COVID-19 vac- cines, according to local news stations. Carle Health in Urbana, Ill., said about 30 un- insured patients were billed $55 for the vaccine, according to a March 16 report from WAND- TV. e health system said it was a result of an error in its billing process, which it quickly worked to fix. e Illinois health system said it reached out to affected patients directly to inform them about the error. "Carle provides care to all who need it and be- lieves concerns about the cost of healthcare should not stop anyone from receiving it," Kayla Banks, vice president of women's and children's services for Carle Health, told WAND-TV. "To- day, we're extending this commitment by again sharing with patients and our communities that Carle will not bill patients directly for the COVID-19 vaccine." Additionally, clinics run by Houston-based Bay- lor College of Medicine mistakenly billed some patients for the COVID-19 vaccine, according to a March 15 report from ABC 13. One patient, Aaron Parks, who spoke to ABC 13, said he received a bill of $79 from the hospital aer getting the COVID-19 vaccine. A second patient, Tarron Hilliard, received a $91 bill from the hospital aer getting the vaccine. A spokesperson for Baylor College of Medicine declined to comment on how many patients received bills in error, but said it is working to notify patients who received statements for the COVID-19 vaccine, according to the report. "BCM policy is to bill insurance companies the allowed vaccine administration fee, but not to bill patients. A billing system error resulted in some patients being billed for the COVID-19 vaccine. is has been corrected and affected patients are being refunded," the spokesperson told ABC 13. n More hospitals billing at highest severity level; HHS suggests targeted reviews of potentially upcoded stays By Alia Paavola H ospitals are increasingly billing inpatient stays at the highest se- verity level, which is also the most expensive one, according to a February report from the HHS Office of Inspector General. The inspector general found that the number of Medicare beneficia- ry hospitalizations billed at the highest severity level increased near- ly 20 percent from fiscal year 2014 to fiscal year 2019. During the same study period, the number of stays billed at the other severity levels decreased. In addition, the average length of stay decreased for hospitalizations with the highest severity level, while the average length of stay remained unchanged for other severity levels. The inspector general said that while the shorter length of stay is not in- herently problematic, the increased number of stays billed at the highest level raises questions about the accuracy and appropriateness of billing and suggests that hospitals may be upcoding Medicare claims. Upcoding is a practice of billing at a level that is higher than warranted. "Although the complications billed suggest sicker beneficiaries, the short- er lengths of stay point to beneficiaries who are less sick. For this reason, these stays suggest potential upcoding," the inspector general said. The office is recommending that CMS start targeted reviews of Medicare Severity Diagnosis Related Groups, stays that are vulnerable to upcoding and the hospitals that frequently bill for the highest severity code. n Banner Health's annual net income falls 19.3% in 2020 to $586.7M By Alia Paavola P hoenix-based Banner Health saw its annual net income fall 19.3 per- cent to $586.7 million in 2020 compared to 2019, according to finan- cial results published in March. Banner Health, which operates 32 hospitals in six states, recorded reve- nue of $10.4 billion in 2020, a nearly $1 billion increase from 2019. The revenue for 2020 included $316 million in recognized federal relief grants. The health system also saw its expenses rise in 2020 to $10.1 billion, up from $9.2 billion recorded in 2019. As a result, Banner posted an operating income of $310.9 million in 2020. Without the federal relief grants, Banner would have posted a slight oper- ating deficit in 2020. In 2019, Banner Health posted an operating income of $200.4 million. "Federal stimulus support dollars have been instrumental in mitigating the financial burden from this crisis," Banner Health said. n

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