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Medicare Compliance Review of North Shore Medical Center for Calendar Years 2009 and 2010

North Shore Medical Center (the Hospital) complied with Medicare billing requirements for 75 of the 316 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 241 claims, resulting in overpayments totaling $816,000 for calendar years 2009 and 2010. These errors occurred primarily because the Hospital did not have adequate controls to prevent the incorrect billing of Medicare claims and did not fully understand the Medicare billing requirements within the selected risk areas that contained errors.