Medicare Compliance Review of West Florida Hospital for Calendar Years 2009 and 2010.

摘要

West Florida Hospital (the Hospital) is a 547-bed acute care hospital located in Pensacola, Florida. Medicare paid the Hospital approximately $117.5 million for 13,881 inpatient and 93,553 outpatient claims for services provided to beneficiaries during calendar years (CY) 2009 and 2010 based on CMSs National Claims History data. Our audit covered $2,021,049 in Medicare payments to the Hospital for 208 claims that we judgmentally selected as potentially at risk for billing errors. These 208 claims had dates of service in CYs 2009 and 2010 and consisted of 200 inpatient and 8 outpatient claims. Our objective was to determine whether the Hospital complied with Medicare requirements for billing inpatient and outpatient services on selected claims.