Knowledge base

Cost Report Fraud

Throughout the course of the fiscal year, certain providers submit claims to their assigned Fiscal Intermediaries for Medicare reimbursement. Generally, these claims are submitted based upon the number of discharged Medicare beneficiaries. To enable them to satisfy their operating need for cash, providers receive periodic interim payments based on estimated Medicare costs. Within a specified time after the end of the fiscal year, usually around April of each year, provider hospitals submit a Form (the “Cost “Report”) to their Fiscal Intermediary, setting out the costs they actually incurred. Including unallowable costs, and inflated costs are common violations of the False Claims Act.

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