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Medicare Compliance Review of Lahey Clinic for Calendar Years 2009 and 2010

Lahey Clinic (the Hospital) complied with Medicare billing requirements for 95 of the 389 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 294 claims, resulting in net overpayments totaling $736,000 for calendar years 2009 and 2010. These overpayments occurred primarily because the Hospital's existing controls did not adequately prevent incorrect billing of these Medicare claims.