Medicare Compliance Review of Saint Luke's Hospital of Chesterfield for 2011 and 2012

Saint Luke's Hospital of Chesterfield (the Hospital) (operating in Missouri) complied with Medicare billing requirements for 174 of the 188 outpatient and inpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 14 claims, resulting in overpayments of $120,000 for calendar years (CYs) 2011 and 2012 (12 claims) and CYs 2010 and 2013 (2 claims). Specifically, five outpatient claims had billing errors, resulting in overpayments of $78,000, and nine inpatient claims had billing errors, resulting in overpayments of $42,000. 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.