Medicare Compliance Review of the University of Kentucky HealthCare for 2011 and 2012

The University of Kentucky HealthCare (the Hospital), located in Lexington, Kentucky, complied with Medicare billing requirements for 154 of the 232 inpatient and outpatient claims that we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 78 claims, resulting in overpayments of $209,000. Specifically, 51 inpatient claims had billing errors resulting in overpayments of $191,000, and 27 outpatient claims had billing errors resulting in overpayments of $18,000. Of the $209,000 in overpayments, $113,000 is within the 3-year recovery period. 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.