Medicare Compliance Review of Oregon Health & Science University for 2010 Through 2012

Oregon Health & Science University (OHSU), located in Portland, Oregon, complied with Medicare billing requirements for 45 of the 102 inpatient claims and all 11 of the outpatient claims we reviewed. However, OHSU did not fully comply with Medicare billing requirements for 57 inpatient claims, resulting in overpayments of $2.4 million for 2010 through 2012. These billing errors occurred primarily because OHSU did not have adequate controls to prevent the incorrect billing of Medicare claims within the selected risk areas that contained errors.