Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review of Duplicate Medicare Fee-for-Services Payments at Regence Blue Shield of Idaho," (A-10-03-00003)

October 24, 2003


Complete Text of Report is available in PDF format (797 KB). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


EXECUTIVE SUMMARY:

The objective of this review was to determine whether costs claimed on Regence BlueShield of Idaho’s Calendar Year 2000 Medicare cost report were in accordance with the Medicare cost principles, and not for services reimbursed under Medicare’s fee-for-service payment system.  We found that generally, Regence prepared the Medicare cost report in accordance with Federal regulations.  However, Regence claimed costs of $39,660 for services provided to beneficiaries under its health maintenance organization contract with Medicare that were previously reimbursed under Medicare’s fee-for-service payment system.