Medicare Compliance Review of Altru Hospital for 2012 and 2013

Altru Hospital (the Hospital) (operating in Grand Forks, North Dakota) complied with Medicare billing requirements for 241 of the 253 outpatient and inpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 12 claims, resulting in overpayments of $66,000. Specifically, nine outpatient claims had billing errors, resulting in overpayments of $39,000, and three inpatient claims had billing errors, resulting in overpayments of $27,000. 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.