Medicare Paid Independent Organ Procurement Organizations Over Half a Million Dollars for Professional and Public Education Overhead Costs That Did Not Meet Medicare Requirements

Submitting OIG:

Date Issued:

Wednesday, August 9, 2023

Agency Reviewed / Investigated:

Submitting OIG-Specific Report Number:

A-09-21-03020

Component, if applicable:

Centers for Medicare & Medicaid Services

Centers for Medicare and Medicaid Services

Location(s):

United States

Type of Report:

Audit

Questioned Costs:

$72,208

Funds for Better Use:

$592,087

Number of Recommendations:

Report updated under NDAA 5274:

View Document:

Attachment	Size
92103020.pdf	1.23 MB

Recommendation Number	Recommendation Status	Significant Recommendation
23-A-09-102.01	Open	No
We recommend that the Centers for Medicare & Medicaid Services instruct Palmetto GBA to recover $72,208 in unallowable Medicare payments by adjusting the applicable OPOs' cost reports to correct the $148,750 of unallowable professional and public education overhead costs reported, consistent with relevant laws and the agency's policies and procedures.
23-A-09-102.02	Open	No
We recommend that the Centers for Medicare & Medicaid Services update applicable Medicare requirements to clarify which types of professional and public education overhead costs are unallowable (e.g., clarify whether the costs of meals provided to non-OPO employees for professional education and the costs of tickets to entertainment events purchased for the purpose of public education are unallowable), which could have saved Medicare an estimated $664,295 for professional and public education overhead costs during our audit period.

Recommendation Number

Recommendation Status

Significant Recommendation

Additional Details

23-A-09-102.01

Open

23-A-09-102.02

Open

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