Gov’t audit insider 3/16/04: OIG checks out NY hospital’s MSP processes
Healthcare Auditing Weekly, March 16, 2004
Office of Inspector General (OIG) auditors urged Maimonides Medical Center in Brooklyn, New York, to continuously update written procedures and Medicare Secondary Payer (MSP) processes, according to a recent audit report.
The hospital's internal controls generally meet the MSP requirements.
The OIG performed the following tasks during the audit:
-Cost avoidances
-MSP adjustment claims
-Other MSP claims
-Non-group health plan claims
-No pay claims
The OIG chose 40 beneficiaries with claims that included one or any of the five characteristics above and then obtained and evaluated the following documentation for each of the sampled beneficiaries:
The MSP questionnaires were not current and consistent enough for the auditors' tastes and Maimonides has responded with tougher internal controls, and improved MSP processes, the hospital told the OIG. Keep your written procedures and other documentation for MSP processes up to date, and in compliance with OIG recommendations.
Click here to view the entire audit report called "Review of Medicare Secondary Payer Processes at Maimonides Medical Center for claims paid between July 1, 2001 and March 31, 2002."
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