Medicare Compliance Review of North Mississippi Medical Center for 2013 and 2014

The North Mississippi Medical Center (the Hospital) (operating in Tupelo, Mississippi) complied with Medicare billing requirements for 158 of the 237 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 79 claims, resulting in overpayments of $41,000 for the audit period. Specifically, 4 inpatient claims had billing errors, resulting in overpayments of $12,000, and 75 outpatient claims had billing errors, resulting in overpayments of $29,000. 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 overpayments of at least $119,000 for the audit period.