Medicare Compliance Review of Barnes Jewish Hospital for Calendar Years 2009 and 2010.

摘要

Barnes Jewish Hospital (the Hospital) has 1,259 beds and is located in St. Louis, Missouri. Medicare paid the Hospital approximately $660 million for 43,084 inpatient and 293,869 outpatient claims for services provided to Medicare beneficiaries during calendar years (CY) 2009 and 2010 based on CMSs National Claims History data. Our audit covered $5,598,277 in Medicare payments to the Hospital for 34 outpatient and 206 inpatient claims that we identified as potentially at risk for billing errors for CYs 2009 and 2010. (Of these 240 claims, 222 had dates of service in CYs 2009 and 2010 and the remaining 18 claims, involving replacement medical devices, had dates of service in CYs 2008 and 2011.) Our objective was to determine whether the Hospital complied with Medicare requirements for billing outpatient and inpatient services on selected claims.