Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review of Cost Report Settlements by Mutual of Omaha (Mutual) for Medicare Inpatient Acute Care Providers Receiving Disproportionate Share (DSH) Payments," (A-07-01-00134)

July 24, 2002


Complete Text of Report is available in PDF format (328 KB). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


EXECUTIVE SUMMARY:

The objective of our review was to determine whether Mutual, at cost report settlement, had correctly calculated providersí disproportionate share hospital (DSH) payments.  We found that Mutual incorrectly calculated DSH payments for two of 45 providers we reviewed, and made other minor settlement errors for one of the two providers with a DSH payment error.  Consequently, Mutual made a net Medicare underpayment of $2,345.  These payment problems occurred because of insufficient supervisory review of cost report settlements.  We brought this to Mutualís attention.  They indicated the cost reports would be reopened and adjusted.  We recommend that the Centers for Medicare & Medicaid Services (CMS):  (i) monitor Mutualís reopening of the cost reports for the two providers with settlement errors identified in our review; and, (ii) ensure that Mutual establishes sufficient supervisory review procedures for cost report settlements.