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Medicare Compliance Review of University of North Carolina Hospitals for the Period January 1, 2011, Through September 30, 2012

University of North Carolina Hospitals (the Hospital), located in Chapel Hill, NC, complied with Medicare billing requirements for 192 of the 251 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 59 claims, resulting in net overpayments of approximately $452,000. On the basis of our sample results, we estimated that the Hospital received overpayments of at least $2.4 million for the audit period. These errors occurred primarily because the Hospital did not have adequate controls to prevent the incorrect billing of Medicare claims within the selected risk areas that contained errors.

Filed under: Center for Medicare and Medicaid Services