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Audit (A-07-13-05043)

12-10-2014
Medicare Compliance Review of Boone Hospital for 2010 and 2011

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Summary

Boone Hospital (the Hospital) (operating in Columbia, Missouri) complied with Medicare billing requirements for 202 of the 307 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 105 claims, resulting in net overpayments of $407,000 for calendar years (CYs) 2010 and 2011 (90 claims) and CYs 2009 and 2012 (15 claims). Specifically, 67 inpatient claims had billing errors, resulting in overpayments of $306,000, and 38 outpatient claims had billing errors, resulting in net overpayments of $101,000. 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.

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