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Audit (A-01-11-00500)

09-26-2011
Medicare Compliance Review of Baystate Medical Center for Calendar Years 2008 and 2009

Executive Summary

Baystate Medical Center (the Hospital) complied with Medicare billing requirements for 138 of the 188 claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for selected inpatient and outpatient claims in other areas. Specifically, of 188 sampled claims, 50 claims had errors in overpayments totaling $325,000 for calendar years 2008 and 2009. Overpayments occurred primarily because the Hospital did not have adequate controls to prevent the incorrect billing of Medicare claims and did not fully understand Medicare billing requirements.

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