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Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review of Cardiac Rehabilitation Services at Butler County Health Care Center, David City, Nebraska," (A-07-03-00157)

January 30, 2004

Complete Text of Report is available in PDF format (411 KB). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


The objectives of this review were to determine whether:  (1) Butler County Health Care Center's (BCHCC) policies and procedures reflected Medicare cardiac rehabilitation coverage requirements for direct physician supervision, “incident to” services, and Medicare covered diagnoses; and (2)  payments to BCHCC for outpatient cardiac rehabilitation services provided to Medicare beneficiaries during Calendar Year 2001 were for Medicare covered diagnoses, were supported by adequate documentation, and were otherwise allowable for reimbursement.  BCHCC did not designate a physician to directly supervise the services provided by its cardiac rehabilitation staff.  In addition, we could not identify the physician professional services to which the cardiac rehabilitation services were provided “incident to.”