Medicare Compliance Review of Saint Luke's Hospital of Kansas City for 2011 and 2012

Saint Luke's Hospital of Kansas City (the Hospital) (operating in Kansas City, Missouri) complied with Medicare billing requirements for 214 of the 294 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 80 claims, resulting in overpayments of $581,000 for calendar years (CYs) 2011 and 2012 (65 claims) and CY 2010 (15 claims). Specifically, 63 inpatient claims had billing errors, resulting in overpayments of $367,000, and 17 outpatient claims had billing errors, resulting in overpayments of $215,000. 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.