Medicare Compliance Review of West Florida Hospital for Calendar Years 2009 and 2010

07-02-2012 | Audit (A-04-11-08010) | Complete Report

West Florida Hospital (the Hospital) complied with Medicare billing requirements for 151 of the 208 inpatient and outpatient claims that we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 57 claims, resulting in overpayments totaling $173,000 for CYs 2009 and 2010. Specifically, 55 inpatient claims had billing errors, resulting in overpayments totaling $145,000, and 2 outpatient claims had billing errors, resulting in overpayments totaling $28,000. Overpayments occurred primarily because the Hospital did not have adequate controls to prevent incorrect billing of Medicare claims, and its staff did not fully understand Medicare billing requirements.

Filed under: Center for Medicare and Medicaid Services