Blue Cross Association Performance as a Medicare Contractor

HRD-79-116: Published: Sep 10, 1979. Publicly Released: Oct 11, 1979.

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An examination was requested of the potential future roles for the Blue Cross Association (BCA) as a Medicare intermediary under contract with the Department of Health, Education, and Welfare and certain aspects of its past performance as the prime contractor for the Blue Cross plans acting as Medicare intermediaries. Information developed by a subcommittee suggested that BCA may have delayed or interfered with the implementation of Medicare's policy on the allowability of Unihealth charges for reimbursement purposes. After studying the major events highlighting the BCA involvement in implementing Medicare's reimbursement policy for Unihealth fees, GAO concluded that BCA did not interfere with policy implementation. A Medicare Bureau evaluation of the period January 1, 1972 to May 31, 1973 revealed other problems; BCA disagreed with the assessment. Because the evaluation was so old, GAO did not attempt to evaluate its findings.

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