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Audit (A-04-07-00033)

06-14-2011
Review of CIGNA Government Services Durable Medical Equipment Regional Carrier Medicare Termination Cost Vouchers for the Period October 1, 2006, Through October 31, 2007

Executive Summary

Of the $2.29 million in Durable Medical Equipment Regional Carrier (DMERC) termination costs reviewed, $1.37 million was allowable for Medicare reimbursement under the DMERC contract. The remaining $923,000 was not. Of this $923,000, we set aside $746,000 for Centers for Medicare & Medicaid Services (CMS) adjudication because it was otherwise allowable under CIGNA's Medicare Part B contract. The remaining $177,000 was unallowable for Medicare reimbursement because CIGNA did not have adequate policies and procedures to ensure that these costs were adequately supported and allocated to the DMERC contract in compliance with Federal regulations and CMS guidance.

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