Federal Reports

This work product summarizes an OIG review of allegations of VA waste, fraud, abuse, or mismanagement. The results of the OIG’s oversight efforts are typically published in a formal report. However, the OIG has issued alternative work products, such as this one, in lieu of a full report in certain circumstances. These included instances in which the OIG could not substantiate an allegation or substantiated an allegation without issuing recommendations, when actions were taken by VA during the course of an ongoing project to remediate errors, or when the subject of an allegation retired or resigned from service prior to the completion of OIG's work. In addition, the OIG has issued work products when investigating allegations involving its own personnel when not in the exclusive purview of other agencies.

Mayo Clinic Florida (the Hospital) complied with Medicare billing requirements for 185 of the 199 inpatient and outpatient claims that we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 14 claims, resulting in net overpayments totaling $71,000. 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 overpayments of at least $103,000 for the audit period.