Review of the Hospital of Saint Raphael's Claims for Inpatient & Outpatient Procedures That Included the Replacement of Medical Devices for Calendar Years 2008 and 2009

The Hospital did not fully comply with Medicare requirements for obtaining credits available from manufacturers and for reporting the appropriate billing codes and charges to reflect the credits it received. The Hospital was overpaid approximately $231,000 ($171,000 outpatient and $60,000 inpatient) and beneficiaries incurred approximately $7,000 in additional copayment costs.