Medicare Compliance Review of Sutter Medical Center, Sacramento

Sutter Medical Center, Sacramento (the Hospital), located in Sacramento, California, complied with Medicare billing requirements for 65 of the 182 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 117 claims, resulting in overpayments of approximately $1 million. These 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.