Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review of the Qualified Pension Plan at Empire Blue Cross Blue Shield for the Period January 1, 1999, Through December 31, 2006," (A-07-07-00253)

April 10, 2008


Complete Text of Report is available in PDF format (767 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


EXECUTIVE SUMMARY:

Empire Blue Cross Blue Shield (Empire), a CMS contractor, properly implemented our prior audit recommendation regarding an earlier review of its Medicare segment pension assets; however, it did not always comply with Federal requirements and the Medicare contracts’ pension segmentation requirements while updating the Medicare segment pension assets from January 1, 1999, through December 31, 2006.  As a result, Empire overstated the Medicare segment pension assets by $131,494.

We recommended that Empire decrease its Medicare segment pension assets as of December 31, 2006, by $131,494.  Empire’s Medicare contract was transferred to National Government Systems (NGS) effective January 1, 2007.  NGS agreed with our recommendation.