Medicare Compliance Review of University of Miami Hospital.

摘要

University of Miami Hospital (the Hospital) is a 560-bed acute care facility located in Miami, Florida. Medicare paid the Hospital approximately $223 million for 20,953 inpatient and 24,535 outpatient claims for services provided to beneficiaries during calendar years 2009 and 2010 based on CMSs National Claims History data. Our audit covered $22,784,260 in Medicare payments to the Hospital for 2,194 claims that were potentially at risk for billing errors. We selected a stratified random sample of 200 inpatient claims with payments totaling $2,905,695 for review. These 200 claims had dates of service from April 1, 2009, through December 31, 2010 (audit period). Our objective was to determine whether the Hospital complied with Medicare requirements for billing inpatient services on selected types of claims.