CMS lists what hospitals were paid under $1.5 billion Medicare appeals settlement

More than 2,000 U.S. hospitals received part of a $1.5 billion settlement from CMS in 2015 to resolve more than 346,000 disputed Medicare claims, and two years after offering the deal, the agency is revealing which hospitals were paid the most.

The top ten on the list were:

  1. New York Presbyterian Hospital: $15.9 million for 1,750 claims.
  2. North Shore University Hospital, Manhasset, New York: $14.5 million for 2,029 claims.
  3. CHI Memorial Hospital, Chattanooga, Tennessee:  $10.9 million for 2,935 claims.
  4. Long Island Jewish Medical Center: $10.8 million for 1,230 claims.
  5. NYU Langone Medical Center: $10.5 million for 1,199 claims.
  6. Lenox Hill Hospital, New York City: $10.3 million for 1,021 claims.
  7. Sanford Medical Center, Sioux Falls, South Dakota: $9.7 million for 1,656 claims.
  8. Thomas Jefferson University Hospital, Philadelphia, Pennsylvania: $8.5 million for 1,642 claims.
  9. UCLA Medical Center: $8.4 million for 1,152 claims.
  10. Eisenhower Medical Center, Rancho Mirage, California: $8.2 million for 1,861 claims.

Some 35 hospitals received more than $5 million each.

The money was offered by CMS in 2014 to resolve years of Medicare billing disputes and reduce the backlog in the appeals process. The agency offered to pay hospitals 68 percent of the value of inpatient claims stuck in the backlog, settling claims for reimbursements for treating Medicare beneficiaries on or before Oct. 1, 2013.

While the settlement amounts were initially not disclosed, CMS released them Aug. 23 in response to a Freedom of Information Act request from Kaiser Health News. 

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John Gregory, Senior Writer

John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.

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