Medicare Compliance Review of Cape Cod Hospital for Calendar Years 2008 and 2009

Cape Cod Hospital (the Hospital) complied with Medicare billing requirements for 178 of the 382 claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for selected inpatient and outpatient claims in other areas. Specifically, of 382 sampled claims, 204 claims had errors in overpayments totaling $379,000 for calendar years 2008 and 2009. Overpayments occurred primarily because the Hospital did not have adequate controls to prevent incorrect billing of Medicare claims and did not fully understand Medicare billing requirements.