Medicare Compliance Review of Loma Linda University Medical Center for 2011 and 2012

Loma Linda University Medical Center (the Hospital), located in Loma Linda, California, complied with Medicare billing requirements for 214 of the 290 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 76 claims, resulting in overpayments of $671,000 for calendar years 2011 and 2012. 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.