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Medicare Compliance Review of Memorial University Medical Center

Issued on  | Posted on  | Report number: A-04-17-08055

Memorial University Medical Center (the Hospital), located in Savannah, Georgia, complied with Medicare billing requirements for 92 of the 131 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 39 claims, resulting in overpayments of $599,530 in calendar year 2015 and 2016. On the basis of our sample results, we estimated that the Hospital received overpayments of at least $1.4 million for the audit period. During the course of the audit, the Hospital submitted some of these claims for reprocessing that we verified as correctly reprocessed. Accordingly, we have reduced the recommended refund by this amount.

18-A-04-067.01 to CMS - Closed Implemented
Closed on 06/15/2018
We recommend that the Hospital refund to the Medicare contractor $1,300,820 ($1,455,892 less $155,072 that has already been repaid) in estimated overpayments for the audit period for claims that it incorrectly billed.

18-A-04-067.02 to CMS - Closed Implemented
Closed on 06/15/2018
We recommend that the Hospital exercise reasonable diligence to identify and return any additional similar overpayments received outside of our audit period, in accordance with the 60-day repayment rule.

18-A-04-067.03 to CMS - Closed Implemented
Closed on 06/15/2018
We recommend that the Hospital strengthen controls to ensure full compliance with Medicare requirements.

View in Recommendation Tracker