Review of Costs of Outpatient Clinics at Coral Gables Hospital

EXECUTIVE SUMMARY:

This audit report points out that Coral Gables Hospital incorrectly reported certain data in its costs reports for Fiscal Years 1996 through 1998. These errors occurred in the accounting and recording of financial and statistical data for clinic activities. A preliminary estimate by the hospital's fiscal intermediary (FI) showed the hospital was overpaid Medicare funds by $384,295. The inappropriate reporting occurred because the hospital lacked sufficient controls in its accounting system to ensure that fiscal data for the clinic operations contained no material errors. Moreover, hospital officials believe that changes in the accounting system contributed to the errors we discovered. We are recommending that the Health Care Financing Administration direct the hospital's FI to (a) adjust the cost reports to correct the errors for FYs 1996 through 1998 , (b) recover the Medicare overpayments of $384,295, and (c) instruct the hospital to ensure that future cost reports are prepared free of the types of errors identified during our audit.