Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review of Medicare Contractor's Pension Segmentation Requirements at Blue Cross Blue Shield of Georgia for January 1, 1993, to May 31, 2001," (A-07-07-00236)

November 16, 2007


The following link is a pdf file Complete Text of Report is available in PDF format (858 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


EXECUTIVE SUMMARY:

The objective of our review was to determine whether Blue Cross Blue Shield of Georgia (Georgia) complied with its Medicare contract’s pension segmentation requirements while implementing the prior audit findings and updating the Medicare segment’s assets from January 1, 1993, to May 31, 2001.  Georgia did not implement the prior audit recommendation to increase Medicare segment assets and did not comply with its Medicare contract’s pension segmentation requirements while updating the segment’s assets from January 1, 1993, to May 31, 2001.  As a result, Georgia understated the May 31, 2001, Medicare segment pension assets by $85,654.

We recommended that Georgia increase Medicare segment pension assets by $85,654 as of May 31, 2001, and implement controls to ensure that the Medicare segment’s assets are updated in accordance with the Medicare contract.  Georgia concurred with our recommendations.