Medicare Compliance Review of Houston Methodist Hospital for 2012 and 2013

Houston Methodist Hospital (the Hospital) located in Houston, Texas, complied with Medicare billing requirements for 111 of the 159 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 48 claims, resulting in net overpayments of $609,000 for the audit period. Additionally, the Hospital did not fully comply with Medicare billing requirements for three of the five separate inpatient claims we reviewed, resulting in overpayments of $68,000. On the basis of our sample results, we estimated that the Hospital received approximately $1.3 million in overpayments from Medicare.