Review of Cardiac Rehabilitation Services at Community Memorial Healthcare, Inc., Marysville, Kansas

EXECUTIVE SUMMARY:

The objectives of this review were to determine whether:  (1) Community Memorial Healthcare's (CMH) policies and procedures reflected Medicare cardiac rehabilitation coverage requirements for direct physician supervision, 'incident to' services, and Medicare covered diagnoses; and (2) payments to CMH for outpatient cardiac rehabilitation services provided to Medicare beneficiaries during Calendar Year (CY) 2001 were for Medicare covered diagnoses, were supported by adequate documentation, and were otherwise allowable for reimbursement.  CMH did not designate a physician to supervise the services provided by its cardiac rehabilitation program.  In addition we could not identify the physician professional services to which the cardiac rehabilitation services were provided 'incident to.'  With regard to the $6,474 of Medicare claims paid for the 18 beneficiaries receiving services during CY 2001, no other problems were noted.