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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 Christian Hospital for 2012 and 2013
Christian Hospital (the Hospital) (operating in Saint Louis, Missouri) complied with Medicare billing requirements for 95 of the 199 outpatient and inpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 104 claims, resulting in overpayments of $341,000 for calendar years 2012 and 2013. Specifically, 89 outpatient claims had billing errors, resulting in overpayments of almost $280,000, and 15 inpatient claims had billing errors, resulting in net overpayments of almost $62,000. 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.
This is a publication by GAO's Inspector General that concerns internal GAO operations. This report addresses the extent to which GAO has established an effective framework of controls to guide its contract management process.
