"Review of Excess Plan Costs Claimed by Blue Cross Blue Shield of South Carolina for Medicare Reimbursement for Fiscal Years 1996�04," (A-07-07-00235)
October 19, 2007
Complete Text of Report is available in PDF format (375 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.
EXECUTIVE SUMMARY:
Blue Cross Blue Shield of South Carolina (South Carolina)
administers Medicare Part A and Part B operations in its Palmetto Government
Benefit Administrators (Palmetto) and TrailBlazer Health Enterprises (TrailBlazer)
subsidiaries under cost reimbursement contracts with the Centers for Medicare &
Medicaid Services. Our objective was to determine the allowability of the
Excess Plan costs that South Carolina claimed for Medicare reimbursement for
fiscal years (FY) 1996�04. We found that South Carolina overclaimed
$1,847,056 in accrued Excess Plan costs
for FYs 1996�04 because it improperly determined costs based on accrual
accounting.
We recommended that South Carolina revise its Final Administrative Cost Proposals
for FYs 1996�04 for Palmetto and FYs 2000�04 for TrailBlazer to reduce
claimed Excess Plan costs by $1,847,056. In written comments on our draft
report, South Carolina did not directly address our recommendation.