Medicare Compliance Review of Massachusetts General Hospital for Calendar Years 2010 and 2011

Massachusetts General Hospital (Mass General) (operating in Boston, MA) complied with Medicare billing requirements for 137 of the 590 inpatient and outpatient claims we reviewed. However, Mass General did not fully comply with Medicare billing requirements for the remaining 453 claims, resulting in net overpayments of approximately $1.2 million for calendar years 2009 through 2012. Overpayments occurred primarily because Mass General did not have adequate controls to prevent the incorrect billing of Medicare claims within the selected risk areas that contained errors.