Department of Health and Human Services

Office of Inspector General -- AUDIT

"Nationwide Review of Improper Medicare Payments for Nonphysician Outpatient Services Under the Prospective Payment System," (A-01-91-00511)

December 29, 1992

Complete Text of Report is available in PDF format (2 MB). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.

EXECUTIVE SUMMARY:

This final audit report points out improper Medicare payments of approximately $38.5 million were made by Medicare fiscal intermediaries (FI) to prospective payment system (PPS) hospitals for nonphysician outpatient services covering the period December 1987 through October 1990. We also identified about $12.9 million due to beneficiaries representing the coinsurance and deductible portions of the improper charges.