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Audit (A-04-10-00075)

11-22-2011
Review of Blue Cross and Blue Shield of Georgia, Inc.'s Medicare Part A Termination Costs for the Period May 5, 2009, Through June 30, 2010

Executive Summary

Most of the costs in Blue Cross and Blue Shield of Georgia, Inc.'s (BCBSGA's), termination vouchers for the period May 5, 2009, through June 30, 2010, were reasonable, allocable, and allowable for Medicare reimbursement. Of the $1.69 million in Medicare Part A termination costs reviewed, $1.51 million was allowable for Medicare reimbursement under the contract. However, the remaining $180,000 was not. Of this amount, $160,000 was not allocable to the contract, $16,000 was unsupported, and $4,000 was unreasonable. BCBSGA claimed these unallowable termination costs because it did not have adequate policies and procedures to ensure that these costs were in compliance with applicable Federal regulations and Centers for Medicare & Medicaid Services guidance.

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