Medicare Compliance Review of Community Medical Center for Calendar Years 2010 and 2011

Community Medical Center (Community) (operating in Montana) did not comply with Medicare billing requirements for all 57 of the outpatient claims with Lupron injections that we reviewed, resulting in overpayments totaling $158,000 for calendar years 2010 and 2011. Overpayments occurred primarily because Community did not have adequate controls to prevent incorrect billing of Medicare outpatient claims with Lupron injections.