Report Materials
EXECUTIVE SUMMARY:
The objective of this review was to determine if payments to Humana (Contract H0307) were appropriate for beneficiaries reported as institutionalized. We determined that Humana received Medicare overpayments totaling $18,645 for 37 beneficiaries incorrectly reported as institutionalized during the period January 1, 1998 through December 31, 2000. The 37 beneficiaries include 23 that did not meet the 30-day residency requirement in an institutional facility, five beneficiaries for whom Humana staff could provide no institutional residency information and 9 beneficiaries residing in non-certified facilities.
Notice
This report may be subject to section 5274 of the National Defense Authorization Act Fiscal Year 2023, 117 Pub. L. 263.