Federal Reports

Billings Clinic Hospital (the Hospital) (operating in Billings, Montana) complied with Medicare billing requirements for 173 of the 179 outpatient and inpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining six claims, resulting in overpayments of approximately $57,000 for calendar years 2012 and 2013. Specifically, five outpatient claims had billing errors, resulting in overpayments of $52,000, and one inpatient claim had a billing error, resulting in an overpayment of $4,500. 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.

ARC awards a Consolidated Technical Assistance grant to the West Virginia Development Office (WVDO) annually to provide funding for technical assistance and outreach to local economic development organizations through the main Street, ON TRAC, and Growing Healthy Communities programs.

Maryland's Department of Health and Mental Hygiene (State agency) did not always comply with Federal and State requirements when it claimed costs for communicable disease care services. Of the 124 claim lines that we sampled, 49 complied with Federal and State requirements; however, 75 did not. On the basis of our sample results, we estimate that the State agency claimed at least $16 million (Federal share) in unallowable costs. The State agency claimed these unallowable costs because it did not have sufficient internal controls to ensure that nursing facilities were correctly claiming communicable disease care services.