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Brought to you by the Council of the Inspectors General on Integrity and Efficiency
Federal Reports
Report Date
Agency Reviewed / Investigated
Report Title
Type
Location
Department of Health & Human Services
Medicare Compliance Review of Boca Raton Regional Hospital, Inc., for 2011 and 2012
Boca Raton Regional Hospital, Inc. (the Hospital), located in Florida, complied with Medicare billing requirements for 161 of the 211 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 50 claims, resulting in overpayments of $514,000 for the audit period. The outpatient claims selected for review did not contain errors. 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. On the basis of our sample results, we estimated that the Hospital received at least $2.6 million in overpayments from Medicare.
The Office of Inspector General released a report examining NASA's education program and its efforts to promote science, technology, engineering, and mathematics (STEM) careers.
CNCS management reported that a CNCS employee may have submitted fraudulent timesheets when she claimed hours not worked. CNCS management terminated the employee and sought $772.96 for hours not worked.
This is a summary of the complete audit report. The Inspector General has determined publically releasing the complete audit report would unacceptably increase the risk to the agency’s information technology systems by disclosing too much information on persistent security deficiencies.
Kindred Hospital of Central Ohio (the Hospital), in Mansfield, Ohio, did not comply with Medicare requirements for billing Kwashiorkor on any of the 77 claims that we reviewed. The Hospital used diagnosis code 260 for Kwashiorkor but should have billed for other forms of malnutrition or no malnutrition at all. For 66 of the inpatient claims, substituting a more appropriate diagnosis code produced no change in the payment amount. For the remaining 11 inpatient claims, the errors resulted in overpayments of $62,000. Hospital officials attributed these errors to a former owner of the hospital and to a lack of clarity in the coding guidelines.
