Medicare Compliance Review of St. Vincent's Medical Center for Calendar Years 2009 and 2010

Executive Summary

St. Vincent's Medical Center (the Hospital) complied with Medicare billing requirements for 157 of the 198 claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for selected inpatient and outpatient claims. Specifically, 41 claims had billing errors that resulted in overpayments totaling $284,773 for calendar years 2009 and 2010. Overpayments occurred primarily because the Hospital did not have adequate controls to prevent incorrect billing of Medicare claims and did not fully understand Medicare billing requirements.