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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 Veterans Affairs
Healthcare Inspection – Review of Antimicrobial Stewardship Programs in VHA Facilities
As the second in a series of debt collection audits, this report addresses the extent to which GAO has established effective controls to prevent or detect reservist differential errors and overpayments and collect any resulting debt.
Abbott Northwestern Hospital (the Hospital) complied with Medicare billing requirements for 88 of the 162 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 74 claims, resulting in overpayments of $934,000 for 2013 and 2014 (audit period). On the basis of our sample results, we estimated that the Hospital received overpayments of at least $8 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.
