Corporate Compliance

Gov't audit insider 3/2/2004: Kansas hospital grabs OIG commendation

Healthcare Auditing Weekly, March 2, 2004

Community Memorial Healthcare (CMH) Hospital, in Marysville Kansas, received the OIG's stamp of approval for its response to an audit of the facility's outpatient cardiac rehabilitation services. Despite OIG findings of inappropriately billed "incident to" services, the auditors praised the hospital for working with its fiscal intermediary to remedy its rehab woes.

In order to assess CMH's compliance with national cardiac rehabilitation program regulations the OIG performed the following tasks:

  • Interviewed staff
  • Reviewed documentation relating to the program, including inpatient medical records, physician referrals, and Medicare reimbursement data
  • Compared CMH's policies and procedures to national standards
  • Reviewed all 18 claims for cardiac rehab services at CMH in FY 2001

    The OIG found no cardiac services to which the hospital's "incident to" services could be attributed. The hospital's policies and procedures did not concisely outline the responsibilities between directing cardiac physicians and the cardiac rehabilitation staff, says the OIG.

    Prompted by the oversight, CMH took the OIG's findings to heart, and contacted their FI in the final days of December. This quick response earned positive feedback from the auditors. Cooperation with your FI, could help you get the boost you need during your next audit.

    Click here to view the OIG audit, called "Review of Cardiac Rehabilitation Services at Community Memorial Healthcare, Inc., Marysville, Kansas (A-07-03-00156)."

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