Medicare Compliance Review of the University of Colorado Hospital for Calendar Years 2008 and 2009.

摘要

The University of Colorado Hospital (the Hospital) has over 400 beds and is located in Aurora, Colorado. Medicare paid the Hospital approximately $262 million for 11,866 inpatient and 327,353 outpatient claims for services provided to Medicare beneficiaries during calendar years (CY) 2008 and 2009 based on CMSs National Claims History data. Our audit covered $7,519,204 in Medicare payments to the Hospital for 137 inpatient and 27 outpatient claims that we identified as potentially at risk for billing errors for CYs 2008 and 2009. (Of these 164 claims, 158 had dates of service in CYs 2008 and 2009 and the remaining 6 claims, involving replacement medical devices, had dates of service in CY 2010.) Our objective was to determine whether the Hospital complied with Medicare requirements for billing inpatient and outpatient services on selected claims.