Report Materials
Some hospitals in Medicare Jurisdiction F did not always claim Medicare graduate medical education (GME) reimbursement for residents in accordance with Federal requirements. Specifically, we found that 41 hospitals claimed residents for the same period as more than 1 full-time equivalent (FTE) on cost reports covering fiscal years (FYs) 2012 and 2013. As a result, 21 of the 41 hospitals received excess Medicare GME reimbursement totaling $365,000.
We recommend that Noridian Healthcare Solutions, which administers the Medicare program for MAC Jurisdiction F (1) recover $365,000 in excess Medicare GME reimbursement paid to 21 hospitals in MAC Jurisdiction F; (2) adjust the direct and indirect FTE counts claimed on the Medicare cost reports covering FYs 2012 and 2013 for each of the hospitals that did not always claim Medicare GME reimbursement in accordance with Federal requirements; (3) develop procedures to ensure that no resident is counted as more than 1 FTE in the calculation of Medicare GME payments; and (4) identify and recover any additional overpayments made to hospitals in MAC Jurisdiction F for residents whose FTE count exceeded 1 on Medicare cost reports submitted after FY 2013.
Notice
This report may be subject to section 5274 of the National Defense Authorization Act Fiscal Year 2023, 117 Pub. L. 263.