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Audit (A-04-10-06131)

Review of Outpatient Brachytherapy Medicare Payments to Lakewood Ranch Medical Center

Executive Summary

Lakewood Ranch Medical Center (Lakewood) met applicable Medicare payment requirements for all 43 claims for catheter insertion, Iodine-125 seeds, and Technetium-99m sources. However, none of the 65 SIR-Sphere claims met applicable Medicare payment requirements, resulting in overpayments of $762,000. Lakewood improperly billed these claims because it did not have policies and procedures to account for partial vial usage or handling, tracking, or proper disposition of the unused portion of a vial, and it did not follow its procedures for ordering brachytherapy sources.

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