Review of Outpatient Cardiac Rehabilitation Services at Anne Arundel Medical Center, Annapolis, Maryland

EXECUTIVE SUMMARY:

The objective of this review was to determine whether Medicare properly reimbursed Anne Arundel Medical Center (Anne Arundel) for outpatient cardiac rehabilitation services.  Even though physician supervision was assumed to be met in an outpatient hospital department, Anne Arundel contracted with a physician to supervise the services provided by its cardiac rehabilitation program.  The physicians' responsibilities included approval of the patients' exercise prescriptions and reviewing patients' progress. We could not determine whether the physician was in the exercise area during regularly scheduled exercise sessions or whether he saw the patients.  In addition, from our specific claims review for a sample of 30 beneficiaries who received outpatient cardiac rehabilitation services during Calendar Year 2001, we determined that Anne Arundel received Medicare payments of $3,997 for services where the diagnoses used to establish the patients' eligibility for cardiac rehabilitation may not have been supported and for services not otherwise allowable.