Medicare Compliance Review of Bay Medical Center for Calendar Years 2009 and 2010

Bay Medical Center (the Hospital), located in Panama City, Florida, complied with Medicare billing requirements for 149 of the 197 inpatient and outpatient claims that we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 48 claims, resulting in overpayments totaling $290,000. Specifically, 43 inpatient claims had billing errors, resulting in net overpayments totaling $271,000, and 5 outpatient claims had billing errors, resulting in net overpayments totaling $18,000. Overpayments occurred primarily because the Hospital did not have adequate controls to prevent incorrect billing of Medicare claims, and its staff did not fully understand Medicare billing requirements.