Audits by federal agencies have revealed that three Blues plans overcharged federal benefits programs by $13 million.
St. Louis-based Blue Choice Plan, an HMO owned by Alliance Blue Cross and Blue Shield of Missouri, paid $6 million to the Federal Employees Health Benefits Program. A 1994 audit by the Office of Personnel Management's inspector general's office found the plan had charged federal employees higher insurance premiums than it charged commercial customers and failed to remit contracted discounts between 1989 and 1995. There was no litigation, and the plan did not admit any wrongdoing
HHS' inspector general's office found that two other Blues plans that have been Medicare fiscal intermediaries and carriers owe HCFA nearly $7 million for unallowable administrative costs and excess Medicare pension assets.
In a report released last week, the agency said Blue Cross and Blue Shield of Texas charged $1.7 million to Medicare for unallowable merger and lobbying costs, executive compensation and fringe benefits from 1994 to 1998. That plan is still a contractor.
Former Medicare contractor Blue Cross and Blue Shield of Massachusetts, whose contract was terminated in 1997, allegedly failed to remit $5.3 million in Medicare pension assets due when the contract was terminated.
The inspector general's auditors recommended repayment by both plans.