Medicare Compliance Followup Review of Boston Medical Center

Boston Medical Center (operating in Massachusetts) complied with Medicare billing requirements for 105 of the 431 inpatient and outpatient claims we reviewed. However, Boston Medical did not fully comply with Medicare billing requirements for the remaining 326 claims, resulting in overpayments totaling $612,000 for calendar years 2009 through 2011. These errors occurred primarily because Boston Medical did not have adequate controls to prevent the incorrect billing of Medicare claims and did not fully understand the Medicare billing requirements within the selected risk areas that contained errors.