Medicare Compliance Review of the Brooklyn Hospital Center for Calendar Years 2010 and 2011

The Brooklyn Hospital Center (the Hospital), operating in New York, complied with Medicare billing requirements for 27 of the 162 claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 135 claims, resulting in overpayments of $545,000 for calendar years 2010 and 2011. Specifically, 112 inpatient claims had billing errors resulting in overpayments of $532,000, and 23 outpatient claims had billing errors resulting in overpayments of $13,000. These overpayments occurred primarily because the Hospital did not have adequate controls to prevent incorrect billing of Medicare claims and its staff did not fully understand the Medicare billing requirements within the selected areas of risk.