Graduate Medical Education for Dental Residents Claimed by University of California at San Francisco Medical Center for Fiscal Years 2000 Through 2002

Our objective was to determine whether the University of California at San Francisco Medical Center (the Hospital) included the appropriate number of dental residents in its full-time equivalent (FTE) counts when computing Medicare graduate medical education (GME) payments for fiscal years (FYs) 2000 through 2002. The Hospital overstated its direct and indirect GME claims by a total of $3,904,526 for FYs 2000 through 2002. The Hospital inappropriately included a total of 153.88 direct GME FTEs and 159.69 indirect GME FTEs in the counts for FYs 2000 through 2002.

We recommended that the Hospital (1) file an amended cost report, which will result in a refund of $3,904,526 associated with FTEs for which the Hospital did not incur all or substantially all of the training costs; (2) establish and follow written procedures to ensure that the FTE counts for residents in nonhospital settings include only those FTEs for which the Hospital has incurred all or substantially all of the training costs; and (3) determine whether errors similar to those identified in our review occurred in Medicare cost reports after FY 2002 and refund any overpayments. The Hospital generally disagreed with our findings and recommendations.