Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review of Blue Cross Blue Shield of Maine's Postretirement Benefit Plan," (A-07-05-00196)

August 8, 2006


Complete Text of Report is available in PDF format (384 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 (1) the allowability of postretirement benefit (PRB) costs Maine claimed for Medicare reimbursement for fiscal years (FY) 1992 through 2000 and (2) the Federal Government’s share of excess Medicare assets resulting from previously funded PRB costs.  Maine did not claim all PRB costs that were allowable for Medicare reimbursement for FYs 1992 through 2000 because it did not claim PRB costs in accordance with the Medicare contract. Therefore, Maine underclaimed $112,044 of allowable PRB costs.  The Federal Government’s share of excess Medicare assets resulting from previously funded PRB costs was $625,306.  The net of these amounts, $513,262, should be remitted to the Federal Government.  We recommended that Maine remit $513,262 to the Federal Government for excess Medicare assets resulting from previously funded PRB costs.  Maine concurred with our recommendation.