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Audit (A-07-09-02757)

10-14-2009
Review of Geographic Classification of Hospital Cayetano Coll y Toste for Medicare Operating Disproportionate Share Hospital Payment

Executive Summary

Geographic classifications used by Cooperativa de Seguros de Vida de Puerto Rico (COSVI), a Medicare fiscal intermediary, to calculate the Medicare operating disproportionate share hospital (operating DSH) adjustment resulted in an overpayment at one hospital. Of the operating DSH adjustment of $1.1 million that Hospital Cayetano Coll y Toste (the Hospital) claimed on its cost report for the fiscal year ending December 31, 2003, $582,000 was excessive because COSVI calculated the operating DSH adjustment as if the Hospital was urban for the entire cost report period. However, the Hospital was rural for the entire cost report period. This resulted in an operating DSH overpayment of $582,000.

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