Submitting OIG:
Report Description:
Mount Sinai Hospital (the Hospital) located in New York, New York, complied with Medicare billing requirements for 151 of the 261 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 110 claims for the audit period (calendar years 2012 and 2013). On the basis of our sample results, we estimated that the Hospital received overpayments totaling at least $41.9 million for the audit period. These errors occurred primarily because the Hospital did not have adequate controls to prevent the incorrect billing of Medicare claims within the selected risk areas that contained errors.
Date Issued:
Monday, April 24, 2017
Agency Reviewed / Investigated:
Submitting OIG-Specific Report Number:
A-02-14-01019
Component, if applicable:
Centers for Medicare & Medicaid Services
External entity, if applicable:
Mount Sinai Hospital
Location(s):
NY
United StatesType of Report:
Audit
Questioned Costs:
$41,869,783
Funds for Better Use:
$0
Number of Recommendations:
4
View Document:
Attachment | Size |
---|---|
21401019.pdf | 4.74 MB |
Additional Details Link: