Audit of Blue Cross/Blue Shield of South Carolina for Medicare Reimbursement
Healthcare Auditing Weekly, November 13, 2007
The OIG found that Blue Cross/Blue Shield of South Carolina incorrectly billed Medicare for $1,847,056 in Excess Plan costs for FYs 1996-2004 because it falsely determined costs based on accrual accounting.
The OIG recommended that:
- South Carolina revise its Final Administrative Cost Proposals for FYs 1996-2004 for Palmetto and FYs 2000-2004 for TrailBlazer to reduce the claimed Excess Plan costs by $1,847,056.
Blue Cross Blue Shield of South Carolina administers Medicare Part A and Part B operations in its Palmetto Government Benefit Administrators and TrailBlazer Health Enterprises subsidiaries under cost reimbursement contracts with the Centers for Medicare & Medicaid Services.
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