Medicare Compliance Review of Aibonito Mennonite General Hospital, Inc., for Calendar Years 2010 and 2011

Aibonito Mennonite General Hospital, Inc. (Mennonite) (operating in Puerto Rico) complied with Medicare billing requirements for 354 of the 423 claims we reviewed. However, Mennonite did not fully comply with Medicare billing requirements for the remaining 69 claims, resulting in overpayments for inpatient claims of $279,000 for calendar years 2010 and 2011. Overpayments occurred because the Hospital did not have adequate controls to prevent incorrect billing of Medicare claims and did not fully understand the Medicare billing requirements within the selected risk areas that contained errors.