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Medicare Compliance Review of Maine Medical Center for Calendar Years 2009 and 2010

Maine Medical Center (the Hospital), located in Portland, Maine, complied with Medicare billing requirements for 114 of the 293 claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 179 claims, resulting in net overpayments totaling $590,000 for calendar years 2008 through 2010. Overpayments occurred primarily because the Hospital did not have adequate controls to prevent incorrect billing of Medicare claims and did not fully understand Medicare billing requirements within the selected areas of risk.