Submitting OIG:
Report Description:
NorthShore University HealthSystem (the Hospital) complied with Medicare billing requirements for 97 of the 190 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 93 claims, resulting in overpayments of $625,000 for CYs 2013 and 2014 (audit period). On the basis of our sample results, we estimated that the Hospital received overpayments totaling at least $4.1 million for the audit period. Overpayments 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:
Thursday, December 22, 2016
Agency Reviewed / Investigated:
Submitting OIG-Specific Report Number:
A-05-15-00044
Component, if applicable:
Centers for Medicare & Medicaid Services
External entity, if applicable:
NorthShore University HealthSystem
Location(s):
IL
United StatesType of Report:
Audit
Questioned Costs:
$4,110,073
Funds for Better Use:
$0
Number of Recommendations:
3
View Document:
Attachment | Size |
---|---|
51500044.pdf | 698.96 KB |
Additional Details Link: