Medicare Compliance Review of New York-Presbyterian Hospital for 2011 and 2012

New York-Presbyterian Hospital (the Hospital) located in New York, New York, complied with Medicare billing requirements for 162 of the 285 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 123 claims for the audit period (calendar years 2011 and 2012). On the basis of our sample results, we estimated that the Hospital received overpayments totaling at least $14.2 million for the audit period. These errors occurred primarily because the Hospital did not have adequate controls to prevent the incorrect billing of Medicare claims within the selected risk areas that contained errors.