Medicare Compliance Review of Rapid City Regional Hospital for Calendar Years 2010 and 2011

Rapid City Regional Hospital (the Hospital) (operating in South Dakota) complied with Medicare billing requirements for 177 of the 251 outpatient and inpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 74 claims, resulting in overpayments totaling $257,000 for calendar years 2010 and 2011. Overpayments occurred primarily because the Hospital's computerized pharmacy and charge systems were not programmed correctly for a drug. Overpayments also occurred because of human error and because the Hospital did not have adequate controls related to reporting manufacturer credits for replaced medical devices.