Review of Cardiac Rehabilitation Services at Butler County Health Care Center, David City, Nebraska

EXECUTIVE SUMMARY:

The objectives of this review were to determine whether:  (1) Butler County Health Care Center's (BCHCC) policies and procedures reflected Medicare cardiac rehabilitation coverage requirements for direct physician supervision, 'incident to' services, and Medicare covered diagnoses; and (2)  payments to BCHCC for outpatient cardiac rehabilitation services provided to Medicare beneficiaries during Calendar Year 2001 were for Medicare covered diagnoses, were supported by adequate documentation, and were otherwise allowable for reimbursement.  BCHCC did not designate a physician to directly supervise the services provided by its cardiac rehabilitation staff.  In addition, we could not identify the physician professional services to which the cardiac rehabilitation services were provided 'incident to.'