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Audit (A-01-10-00504)

Review of Yale New Haven Hospital Claims for Outpatient Procedures that Included the Replacement of Medical Devices for Calendar years 2007 and 2008

Executive Summary

The Hospital did not fully comply with Medicare requirements for obtaining credits available from manufacturers for replaced medical devices and for reporting the appropriate modifier and charges to reflect the credits received. The Hospital was overpaid $27,000 and beneficiaries incurred $1,800 in additional copayment costs.

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Exclusions Database Report Fraud

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