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Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review of High-Dollar Part B Claims Processed by Cahaba Government Benefits Administrators Carrier No. 00510 for the Period January 1, 2004, Through December 31, 2006," (A-04-08-00041)

June 20, 2008

PDF FileComplete Text of Report is available in PDF format (195 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.

EXECUTIVE SUMMARY:

During calendar years 2004–2006, Cahaba Government Benefit Administrators Carrier No. 00510 (the contractor) overpaid providers in Alabama $121,000.  Generally, the contractor made the overpayments because the providers incorrectly billed excessive units of service.  In addition, the Medicare claims processing systems did not have sufficient edits in place during calendar years 2004–2006 to detect and prevent payments for these types of erroneous claims.  We recommend that the contractor recover the identified overpayments.  The contractor agreed with our recommendations.