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Audit (A-01-10-00506)

Review of Lahey Clinic's Claims for Outpatient Procedures That Included the Replacement of Medical Devices for Calendar Years 2007 and 2008

Executive Summary

Lahey Clinic (the Hospital) did not fully comply with Medicare requirements for obtaining credits available from manufacturers for replaced medical devices and for reporting the appropriate modifiers and changes to reflect the credits received. As a result, for 10 claims the Clinic was overpaid $120,000 and the beneficiary incurred $4,000 in additional copayment costs.

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Exclusions Database Report Fraud

Office of Inspector General, U.S. Department of Health and Human Services | 330 Independence Avenue, SW, Washington, DC 20201