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Audit (A-04-11-08003)

Medicare Compliance Review of Tallahassee Memorial HealthCare, Inc. for Calendar Years 2009 and 2010

Executive Summary

Tallahassee Memorial HealthCare, Inc. (Tallahassee Memorial) complied with Medicare billing requirements for services on 153 of the 167 sampled claims. However, Tallahassee Memorial did not fully comply with Medicare billing requirements for 14 inpatient and outpatient claims. Specifically, these 14 claims had billing errors that resulted in overpayments totaling approximately $130,000 for calendar years 2009 and 2010. Overpayments occurred primarily because Tallahassee Memorial did not have adequate controls to prevent incorrect billing of Medicare claims, and its staff did not fully understand the Medicare billing requirements.

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