Review of Duplicate Medicare Fee-for-Services Payments at Regence Blue Shield of Idaho

EXECUTIVE SUMMARY:

The objective of this review was to determine whether costs claimed on Regence BlueShield of Idaho's Calendar Year 2000 Medicare cost report were in accordance with the Medicare cost principles, and not for services reimbursed under Medicare's fee-for-service payment system.  We found that generally, Regence prepared the Medicare cost report in accordance with Federal regulations.  However, Regence claimed costs of $39,660 for services provided to beneficiaries under its health maintenance organization contract with Medicare that were previously reimbursed under Medicare's fee-for-service payment system.