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Audit (A-01-11-00520)

09-14-2011
Review of Outpatient Claims Processed by Palmetto GBA That Included Procedures for the Insertion Of Multiple Units of the Same Type of Medical Device in Calendar Years 2008 and 2009

Executive Summary

Of the 45 claims that we reviewed, Medicare paid 13 incorrectly for outpatient claims processed by Palmetto GBA, LLC, that included procedures for the insertion of multiple units of the same type of medical device. These incorrect payments were due to hospitals overstating the number of units and related charges, resulting in net overpayments to hospitals totaling approximately $41,000.

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