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Audit (A-02-11-01023)

09-21-2012
Medicare Compliance Review of Centro Cardiovascular de Puerto Rico y del Caribe for the Period January 1, 2008, through June 30, 2010

Executive Summary

Centro Cardiovascular de Puerto Rico y del Caribe (Cardiovascular) complied with Medicare requirements for billing inpatient and outpatient services for 157 of the 171 claims we reviewed. However, Cardiovascular did not fully comply with Medicare billing requirements for the remaining 14 claims, resulting in overpayments totaling $72,000 for the period January 1, 2008, through June 30, 2010. Specifically, 3 inpatient claims had billing errors resulting in overpayments of $33,000, and 11 outpatient claims had billing errors resulting in overpayments of $39,000. These overpayments occurred primarily because Cardiovascular did not have adequate controls to prevent incorrect billing of Medicare claims.

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