Medicare Compliance Review of Bryan Medical Center for Calendar Years 2010 and 2011

Bryan Medical Center (the Hospital) (operating in Nebraska) complied with Medicare billing requirements for 112 of the 142 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 30 claims, resulting in net overpayments of $255,000 for calendar years (CYs) 2010 and 2011 (14 claims) and CYs 2009 and 2012 (16 claims). Specifically, 27 inpatient claims had billing errors, resulting in overpayments of approximately $206,000, and 3 outpatient claims had billing errors, resulting in net overpayments of approximately $48,000. These errors 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.