Review of Supplemental Claim Submitted by the Connecticut General Life Insurance Company (CGLIC)

EXECUTIVE SUMMARY:

By letter dated August 27, 1999; CGLIC submitted a claim under its Medicare contract for $16,177,473 of additional costs for the period October 1, 1989 through September 30, 1997.  The CMS' Contracting Officer requested that our office review the allowability of the additional costs to assist them in evaluating the appropriateness of the claim.  Our review led to a Negotiated Settlement Agreement between CMS and CGLIC, executed on August 2, 2001, that reduced the claimed costs by $15,081,097.  The remaining $1,096,376 represented a negotiated settlement of costs that CMS will reimburse CGLIC under the terms of the Medicare contracts.