Medicare Overpayments in Jurisdiction 15 for Unreported Cardiac Device Credits.

摘要

The Centers for Medicare & Medicaid Services (CMS) pays Medicare claims through the Medicare administrative contractor or fiscal intermediary (Medicare contractor) in each Medicare jurisdiction. For calendar year 2011, Medicare contractors nationwide paid hospitals $243.7 million for certain inpatient and outpatient cardiac medical device claims potentially eligible for a manufacturers credit. Previous Office of Inspector General hospital compliance reviews of inpatient and outpatient manufacturers credits for replaced cardiac medical devices found that Medicare contractors overpaid hospitals for selected claims. The objective of this review was to determine whether payments that Medicare contractors for Jurisdiction 15 made to hospitals for selected inpatient and outpatient claims for replaced cardiac medical devices were in accordance with Medicare requirements.