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Audit (A-03-11-00010)

04-09-2012
Medicare Compliance Review of Georgetown University Hospital for Calendar Years 2009 and 2010

Executive Summary

Georgetown University Hospital (the Hospital) complied with Medicare billing requirements for 131 of the 265 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 134 claims, resulting in overpayments totaling $659,000 for calendar years 2009 and 2010. These overpayments occurred primarily because the Hospital did not have adequate controls over some areas to prevent incorrect billing and coding of Medicare claims or did not fully understand the Medicare billing requirements in these areas.

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