Review of Medicaid and Medicare Credit Balances at Meriter Hospital, Madison, Wisconsin

The objective of this review was to determine if Medicaid and Medicare credit balances recorded on Meriter Hospital's accounting records represent overpayments that should have been reported to those programs.  A credit balance occurs when reimbursement for services exceeds the charges billed according to the provider's accounting records.  We found Medicaid overpayments totaling $205,679 and Medicare overpayments totaling $766 were not reported in a timely manner.  Therefore, we recommended Meriter ensure that the federal share of the overpayments are recovered by the respective programs.  We attribute the untimely identification and reporting of credit balances to provider personnel not being aware of the Medicaid and Medicare reporting requirement and provider policies and procedures not being in accordance with federal and state credit balance reporting requirements.