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Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review of Medicare Contractor's Pension Segmentation, Pennsylvania Blue Shield," (A-07-93-00712)

May 6, 1994


Complete Text of Report is available in PDF format (1.1 MB). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.

EXECUTIVE SUMMARY:

This final audit report points out that Pennsylvania Blue Shield (PBS) omitted Medicare cost centers and misidentified Medicare participants in its calculation of the 1981 Medicare asset fraction. As a result pension assets of the Medicare segment were understated by $616,636 as of January 1, 1986. The PBS' update of the Medicare segment assets to January 1, 1992 understated the assets by an additional $412,751 due to the prior error. We recommended that PBS increase the January 1, 1992 asset base of the Medicare segment by $1,029,387.