关键词：电子信息；信息系统；医疗保险；审查
摘 要：Highmark Medicare Services, Inc. (Highmark) is a Medicare Administrative Contractor (MAC) under contract with CMS to administer the Medicare Part A (hospital insurance) program. Highmark administers the program for MAC Jurisdiction 12, which consists offour StatesPennsylvania, Maryland, New Jersey, and Delaware-and the District of Columbia. For fiscal year (FY) ended 2006, 133 hospitals in MAC Jurisdiction 12 collected and reported information to the IRIS on residents. In FY ended 2007, the figure was 132 hospitals. National Government Services, Inc. (NGS) is a MAC under contract with CMS to administer the Medicare Part A program for MAC Jurisdiction 13, which consists oftwo States-New York and Connecticut. For FY ended 2006, 139 hospitals in MAC Jurisdiction 13 collected and reported information to the IRIS on residents. In FY ended 2007, the figure was 137 hospitals. The objective of our review was to determine whether hospitals in MAC Jurisdiction 12 claimed Medicare GME reimbursement for residents also claimed by hospitals in MAC Jurisdiction 13 in accordance with Federal requirements.