Review of Outpatient Cardiac Rehabilitation Services - Morton Plant Hospital

EXECUTIVE SUMMARY:

The objective of this review was to determine whether Medicare properly reimbursed Morton Plant Hospital for outpatient cardiac rehabilitation services.  We found no documentation to support physician supervision during exercise sessions.  In addition, we did not find sufficient evidence in the medical records to indicate that the cardiac rehabilitation services were provided 'incident to' the medical director's professional services.  Also, from our claims review for 30 sampled beneficiaries who received outpatient cardiac rehabilitation services during calendar year 2001, we determined that the hospital received Medicare payments of $4,426 for services provided to beneficiaries where medical documentation may not have supported Medicare covered diagnoses and for services not otherwise allowable. We recommended correction of internal control weaknesses and other procedural improvements.