Medicare Compliance Review of Yale-New Haven Hospital for 2010 and 2011

Yale-New Haven Hospital (the Hospital) (operating in Connecticut) complied with Medicare billing requirements for 79 of the 192 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 113 claims, resulting in overpayments of approximately $1.7 million for calendar years 2010 through 2011. Overpayments occurred primarily because the Hospital did not have adequate controls to prevent the incorrect billing of Medicare claims within the selected risk areas that contained errors.