Department of Health and Human Services

Office of Inspector General -- AUDIT

"Inpatient Hemodialysis Procedure Services Provided by Vista Del Mar Medical Group, Inc.," (A-09-01-00084)

November 14, 2001


Complete Text of Report is available in PDF format (697 KB). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


EXECUTIVE SUMMARY:

This audit report presents the results of our review of inpatient hemodialysis procedure services provided to Medicare beneficiaries by Vista Del Mar Medical Group, Inc. (Group) in Calendar Years 1998 and 1999.  Based on a review of a statistical sample of Medicare claims, we are 95 percent confident that that the Group received a total overpayment of at least $151,566.  We recommended that the Group refund the overpayment to the Medicare program.  We also recommended that the Group develop policies and procedures to ensure that the Medicare requirements for billing hemodialysis procedure services were met before billing Medicare for such services.