Medicare Compliance Review of Fletcher Allen Health Care for Calendar Years 2008 and 2009

Fletcher Allen Health Care, Inc. (the Hospital), complied with Medicare billing requirements for 162 of the 202 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 the 202 sampled claims, 40 claims had errors in overpayments totaling $234,000 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.