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

Tufts Medical Center (the Hospital), located in Boston, Massachusetts, complied with Medicare billing requirements for 78 of the 209 claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 131 claims, resulting in net overpayments totaling $695,000 for calendar years 2009 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.