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Report File
Date Issued
Submitting OIG
Department of Health & Human Services OIG
Other Participating OIGs
Department of Health & Human Services OIG
Agencies Reviewed/Investigated
Department of Health & Human Services
Components
Centers for Medicare and Medicaid Services
Report Number
A-09-22-03007
Report Type
Audit
Number of Recommendations
5
Questioned Costs
$39,310,499
Funds for Better Use
$0

Open Recommendations

This report has 3 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
22-A-09-102.01 No $39,310,499 $0

We recommend that the Centers for Medicare & Medicaid Services: direct the MACs to recover from acute-care hospitals the portion of the $39,310,499 in identified improper payments for our audit period that are within the 4-year reopening period in accordance with CMS's policies and procedures;

22-A-09-102.03 No $0 $0

based upon the results of this audit, notify appropriate providers (i.e., those for whom CMS determines this audit constitutes credible information of potential overpayments) so that the providers can exercise reasonable diligence to identify, report, and return any overpayments in accordance with the 60-day rule and identify any of those returned overpayments as having been made in accordance with this recommendation;

22-A-09-102.04 No $0 $0

identify any outpatient claims after our audit period for services provided to beneficiaries who were inpatients of other facilities and direct the MACs to recover any improper payments;

Department of Health & Human Services OIG

United States