Medicare Compliance Review of University of Wisconsin Hospital and Clinics for Calendar Years 2008 Through 2010.

摘要

This review is part of a series of hospital compliance reviews. Using computer matching, data mining, and data analysis techniques, we identified hospital claims that are at risk for noncompliance with Medicare billing requirements. For calendar year (CY) 2011, Medicare paid hospitals $151 billion, which represented 45 percent of all fee-for-service payments; therefore, the Office of Inspector General must provide continual and adequate oversight of Medicare payments to hospitals. The objective of this review was to determine whether University of Wisconsin Hospital and Clinics (the Hospital) complied with Medicare requirements for billing inpatient and outpatient services on selected claims.