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Audit (A-04-13-04012)

04-23-2014
Medicare Compliance Review of Duke University Hospital for the Period January 1, 2011, Through September 30, 2012

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Summary

Duke University Hospital (the Hospital operating in North Carolina) complied with Medicare billing requirements for 179 of the 251 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 72 claims, resulting in estimated overpayments of at least $626,000 during the period January 1, 2011, through September 30, 2012. These errors occurred primarily because the Hospital did not have adequate controls to prevent the incorrect billing of Medicare claims within the selected risk areas that contained errors.

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