Review of Periodic Interim Payments Made by Blue Cross of Western Pennsylvania

EXECUTIVE SUMMARY:

This report points out that Blue Cross of Western Pennsylvania (BCWP) made erroneous payments of about $2.7 million to 14 hospitals under the Periodic Interim Payment reimbursement method. The BCWP has done little to recover the overpayments, and has failed to comply with Medicare recovery guidelines. As a result, less than $200,000 has been recovered, or about 6 percent of the $2.7 million owed to Medicare.