Medicare Compliance Review of University of Utah Hospital for Calendar Years 2009 and 2010.

摘要

The University of Utah Hospital (the Hospital) has 535 beds and is located in Salt Lake City, Utah. Medicare paid the Hospital approximately $259 million for 294,944 outpatient and 13,985 inpatient claims for services provided to Medicare beneficiaries during calendar years (CYs) 2009 and 2010 based on CMSs National Claims History data. Our audit covered $5,437,897 in Medicare payments to the Hospital for 243 claims that we judgmentally selected as potentially at risk for billing errors. These claims consisted of 164 outpatient and 79 inpatient claims with dates of service in CYs 2009 or 2010. Our objective was to determine whether the Hospital complied with Medicare requirements for billing outpatient and inpatient services on selected claims.