Medicare Compliance Review of Naples Community Hospital for 2011 and 2012

Naples Community Hospital (the Hospital), located in Naples, Florida, complied with Medicare billing requirements for 134 of the 225 inpatient claims that we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 91 claims, resulting in net overpayments totaling $409,000. 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. On the basis of our sample results, we estimated that the Hospital received at least $4.5 million in overpayments from Medicare.