Pension segmentation requirements reviewed at a terminated Medicare contractor
Healthcare Auditing Weekly, May 20, 2008
According to an OIG report, the Regence Group overstated the Oregon Medicare segment assets by $1.75 million and understated the Utah Medicare segment assets by $28,000. This occurred because the CMS contractor did not follow the Medicare contract’s pension segmentation requirements while updating the Medicare segments’ assets from January 1, 1997, to January 1, 2006. Until the contractual relationship ended November 30, 2005, Regence administered both Medicare Part A and Part B operations under cost reimbursement contracts with CMS
Regence also did not calculate Medicare’s share of the excess pension liabilities. The OIG determined Medicare’s share of the overstated pension to be $1.74 million.
The OIG advised Regence to:
- lower the Oregon Medicare segment pension assets by $1,749,136, and raise the Utah Medicare segment pension assets by $28,000 as of January 1, 2006
- recognize $1.74 million as Medicare’s share of the excess pension liabilities attributable to the segment closing calculation
Regence agreed with the audit results but not with the value of the participant liabilities used in the calculation of the segment closing.
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