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Audit (A-07-11-05013)

07-18-2011
Review of Medicare Fee-for-Service Payments Made by TrailBlazer Health Enterprises, LLC, for Medicare Advantage Enrollees During Calendar Years 2007 and 2008

Executive Summary

Medicare fee-for-service payments made by TrailBlazer Health Enterprises, LLC (TrailBlazer), a Centers for Medicare & Medicaid Services contractor, to hospitals for inpatient services furnished to Medicare Advantage enrollees did not always comply with Federal regulations. TrailBlazer made $472,000 in unallowable payments to hospitals for inpatient claims for beneficiaries who were enrolled in Medicare Advantage plans.

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