Follow-up Review of Radiology Services Paid by Empire Blue Cross Blue Shield Under the Medicare Part B Program

EXECUTIVE SUMMARY:

This audit looked at actions taken by the Health Care Financing Administration (HCFA) and the auditee, Empire Blue Cross Blue Shield (Empire) to ensure the implementation of recommendations contained in our prior report. We found that Empire had taken little action to recover $1.3 million of overpayments recommended for adjustments in the prior report. In addition, HCFA had not initiated sufficient monitoring action to ensure that overpayments were recovered by Empire, nor to assure that actions taken by Empire to preclude future overpayments were effective.