Complete Text of Report is available in PDF format
(146 KB). Copies can also be obtained by contacting the Office of Public Affairs
at 202-619-1343.Complete Text of Report is available in PDF format
(146 KB). Copies can also be obtained by contacting the Office of Public Affairs
at 202-619-1343.EXECUTIVE SUMMARY:
Effective December 1, 1996, California Physicians' Service, dba Blue Shield of California (BSC), voluntarily withdrew from the Medicare program as a carrier. During the period December 1, 1996 through November 30, 1997 BSC claimed termination costs totaling $2,813,246. The termination costs charged to Medicare were overstated by $574,615. The overstatement consisted of improperly allocated severance costs, unallowable building reconfiguration costs, unapproved professional fees, and unallowable outplacement services costs. We recommended that BSC reduce its Medicare claim for the $574,615 in overstated costs.
We also set aside building reconfiguration costs of $85,148 for the Health Care Financing Administration's determination because BSC was unable to provide the needed documentation to support that these costs were Medicare related.
