Medicare Compliance Review of University of California, San Francisco, Medical Center for Calendar Years 2008 and 2009.

摘要

University of California, San Francisco, Medical Center (the Hospital) is an acute-care hospital located in San Francisco, California. Medicare paid the Hospital approximately $499 million for 17,409 inpatient and 386,492 outpatient claims for services provided to beneficiaries during calendar years (CY) 2008 and 2009 based on CMSs National Claims History data. Our audit covered $4,394,664 in Medicare payments to the Hospital for 215 claims that we judgmentally selected as potentially at risk for billing errors. These claims had dates of service in CYs 2008 and 2009 and consisted of 160 inpatient and 55 outpatient claims. Our objective was to determine whether the Hospital complied with Medicare requirements for billing inpatient and outpatient services on selected claims.