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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
Audit of Costs Normally Treated as Administrative and Clerical Costs but Charged Directly to HHS Awards at the University of Louisville
The University of Louisville did not always claim selected costs charged directly to HHS awards in accordance with Federal regulations and, where appropriate, NIH guidelines. In our sample of 120 salary transactions, 102 were allowable but 18 were not. In addition, in our sample of 100 nonsalary transactions, 61 were allowable but 39 were not. These unallowable transactions occurred because the University did not provide adequate oversight to ensure consistent compliance with Federal regulations.
University of Mississippi Medical Center (the Hospital) (operating in Jackson, Mississippi) complied with Medicare billing requirements for 137 of the 217 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 80 claims, resulting in net overpayments of $68,000 for the audit period. Specifically, 12 inpatient claims had billing errors, resulting in net overpayments of $41,000 and 68 outpatient claims had billing errors, resulting in net overpayments of $27,000. 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 net overpayments of at least $356,000 for the audit period.
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.
Evaluation of Non-Defense Criminal Investigative Organization Components’ Compliance with DoD Instruction 5505.16, “Criminal Investigations by Personnel Who Are Not Assigned to a Defense Criminal Investigative Organization”
