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Review of Medicare Payments for Beneficiaries with Institutional Status, UnitedHealthCare of Florida, Sunrise, Florida

Issued on  | Posted on  | Report number: A-05-01-00091

Report Materials

EXECUTIVE SUMMARY:

The objective of this audit was to determine if payments to UnitedHealthcare (United) under Contract H9011 were appropriate for beneficiaries reported as institutionalized.  We determined that United received Medicare overpayments totaling $121,023 for 127 beneficiaries incorrectly reported as institutionalized during the period January 1, 1998 through December 31, 2000.  Reasons for questioning the institutional status of the beneficiaries included: no documentation of institutional residency, admit or discharge dates during the required 30 day residency period, and issues related to hospital stays.

Report Type
Audit
HHS Agencies
Centers for Medicare and Medicaid Services
Issue Areas
-
Target Groups
-
Financial Groups
-

Notice

This report may be subject to section 5274 of the National Defense Authorization Act Fiscal Year 2023, 117 Pub. L. 263.