Cox Branson to return $123K in Medicare payments

Of $1.15 million in Medicare payments received by Cox Medical Center Branson, between 2010 and 2013, the hospital has agreed to repay $123,000 after federal scrutiny connected the billings to treating a rare form of malnutrition usually discovered in third-world countries.

According to the Department of Health and Human Services, Cox Branson’s Medicare claims treated Kwashiorkor in 59 of 112 patient claims. An audit by the department’s Office of Inspector General determined none of the 59 Kwashiorkor claims were legitimate.

The OIG said in 21 of those claims, Medicare payments would have been unchanged.

In a statement, Cox officials said, "The issue regarding the Kwashiorkor diagnosis code was caused in part by the encoding system we were using at the time. Cox Branson was presented the finding of the review and as a result, is prepared to make all necessary refunds to Medicare. All staff have been educated and changes have been made to the coding systems to help resolve this issue."

Cox is among at least five hospital systems the Office of Inspector General is cracking down on after the federal program paid $711 million for Kwashiorkor claims in 2010 and 2011.

Kwashiorkor is a severe form of protein deficiency typically found in children in tropical and subtropical countries and characterized by a distended belly. Cases in the United States are extremely rare. 

Read more from Branson Tri-Lakes News and KCUR.