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Audit (A-01-10-00503)

Review of UMass Memorial Medical Center Claims for Outpatient Procedures that Included the Replacement of Medical Devices for Calendar Years 2007 and 2008

Executive Summary

UMass Memorial Medical Center (the Hospital) generally complied with Medicare requirements for obtaining credits available from manufacturers for replaced medical devices. However, it did not fully comply with requirements for reporting the appropriate modifier and charges to reflect the credits received. As a result, for three claims the Hospital was overpaid $34,000 and beneficiaries incurred $1,400 in additional copayment costs.

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