Medicare Compliance Review of Fletcher Allen Health Care for Calendar Years 2008 and 2009

摘要

Fletcher Allen Health Care, Inc. (the Hospital) is a 419-bed teaching hospital located in Burlington, Vermont. Medicare paid the Hospital approximately $307 million for 15,919 inpatient and 398,178 outpatient claims for services provided to beneficiaries during calendar years (CYs) 2008 and 2009 based on CMSs National Claims History data. Our audit covered $3,363,543 in Medicare payments to the Hospital for 80 inpatient and 122 outpatient claims that we identified as potentially at risk for billing errors. These 202 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.