Medicare Compliance Review of Springhill Medical Centers for Calendar Years 2008 and 2009

摘要

Springhill Medical Center (the Hospital) is a 252-bed acute care hospital located in Mobile, Alabama. Medicare paid the hospital approximately $59 million for 6,586 inpatient and 36,478 outpatient claims for services provided to beneficiaries during calendar years (CY) 2008 and 2009 based on CMSs National Claims History data. Our audit covered $1,631,288 in Medicare payments to the Hospital for 90 inpatient and 92 outpatient claims that we identified as potentially at risk for billing errors. These 182 claims had dates of service in CYs 2008 and 2009. Our objective was to determine whether the Hospital complied with Medicare requirements for billing inpatient and outpatient services on selected claims.