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Audit (A-04-05-02011)

Review of Comprehensive Outpatient Rehabilitation Facility Therapy Services Provided by Care Alliance of America, Inc.

Executive Summary

Care Alliance of America, Inc., a comprehensive outpatient rehabilitation facility in Florida, received an estimated $1.7 million for outpatient therapy services that did not meet Medicare reimbursement requirements for calendar year 2003.

Care Alliance did not always follow Medicare requirements or its own policies and procedures for reporting service units, ensuring that therapy services were adequately documented and complied with the written plan of treatment, or determining medical necessity.

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Office of Inspector General, U.S. Department of Health and Human Services | 330 Independence Avenue, SW, Washington, DC 20201