BIDDEFORD — Officials at Southern Maine Health Center say that a coding error has caused the hospital to be penalized by Medicare. 

The Centers for Medicare and Medicaid Services recently announced that 751 hospitals across the country were to be fined for high rates of injury and infections. 

The rating system was established under the Affordable Care Act to encourage hospitals to take measures to prevent medical conditions or complications that occur during a hospital stay, according to information from Quality Net, an online informational portal for Centers for Medicare & Medicaid Services.

Hospitals that don’t meet performance standards are subject to a one percent decrease of medicare payments. 

Four hospitals in the state were on the list – Southern Maine Health Care in Biddeford, Central Maine Medical Center in Lewiston, Cary Medical Center in Caribou and York Hospital in York. 

SMHC Vice President of Quality and Safety Nathan Wilson said hospital officials were very surprised to hear the hospital was on the list of those being fined.

“We have very high safety standards,” said Wilson. 

Wilson said the Centers for Medicare and Medicaid Services uses several different measures to rate hospitals, and SMHC was penalized due to employee coding errors. He said a code for a medical condition was added to the files of a number of patients that did not have the condition.  

Wilson said moving forward, the hospital will make sure coding is done more accurately. The hospital is implementing software that provides safeguards against coding errors in the future. 

Wilson said  the data used by the Centers for Medicare and Medicaid Services is between a year and  3 1/2 years old, and coding from more than two years ago can not be appealed. 

Wilson said he can’t predict the future, but he believes the hospital has put enough measures in place that this designation by the Centers for Medicare and Medicaid Services will not be a reoccurring event. 

Staff Writer Liz Gotthelf can be contacted at 282-1535, ext. 325 or [email protected] 


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