OIG find overpayments in The Center for Living and Working Inc. in MA
Compliance Monitor, December 5, 2007
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The OIG reviewed personal care services claimed by The Center for Living and Working Inc. in Worcester, MA in order to determine whether the Center claimed personal care services in agreement with Medicare.
The OIG found:
- the Center did not always claim personal care services in agreement with Medicare from 2003 through 2005
- errors totaling $20,552 for services that were provided by personal care attendants on dates when beneficiaries were hospital inpatients and for services that were not correctly documented or authorized
- based on the sample results, the Center received overpayments of $493,777
- the errors were because of the Center's lack of adequate procedures to ensure that it followed Medicare rules when claiming reimbursement for services
The OIG recommended:
- the Center refund the state agency $493,777
- enhance procedures to ensure that it claims PCA services in agreement with Medicare
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