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CMS, through its contractor PalmettoGBA, began an audit of Atrium in 2022 that focused on whether or not the hospital had been correctly reporting its 'domestic care' expenses (the cost of the care it rendered to its own employees) for the last 26 years.

Based on information provided to me by CMS in response to my FOIA requests concerning MTN 695838, the last document in the audit is dated 9/11/23 and is from the auditor to the CMS official.

It closes with this:

"Based on the ruling [a PRRB ruling] the provider's claim of meeting the exception would be voided. If the determination holds, additional questions would be raised regarding the reimbursement impact of the information...Should Palmetto proceed under the context that the [sic] Atrium and MedCost are related and determine the extent to which health insurance costs are not properly reported?"

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It is pasted below as a PDF.

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Tonight (2/24/25) I asked Senator Tillis to find out for me what happened to this audit.

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I will update this site with his response when I get it.

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When an employee of a self-funded hospital receives care from its employer/hospital the 'transaction' is between the hospital as the medical provider and the self-funded hospital as the payer (and, of course, the employee as the payer of the employee's portion).

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The reason the Atrium's claim to meet the exception is 'voided' is because in order to meet the exception the two entities involved in the transaction have to be 'bona fide separate entities'. Atrium (as the medical provider) and Atrium (as the self-funded purchaser of medical services for its employee are not 'bona fide separate entities'.

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