Why OIG Did This Audit
The Centers for Medicare & Medicaid Services (CMS) reimburses Medicare contractors for a portion of their pension costs, which are funded by the annual contributions that these contractors make to their pension plans.
At CMS’s request, the U.S. Department of Health and Human Services, Office of Inspector General (OIG), Office of Audit Services, Region VII pension audit team reviews the cost elements related to qualified defined-benefit, postretirement benefit, and any other pension-related cost elements claimed by Medicare contractors through Incurred Cost Proposals (ICPs).
Previous OIG audits found that Medicare contractors did not always comply with Federal requirements when claiming pension costs for Medicare reimbursement.
Our objective was to determine whether the calendar years (CYs) 2014 through 2016 qualified defined-benefit plan pension costs that Cahaba Safeguard Administrators, LLC (Cahaba CSA), claimed for Medicare reimbursement, and reported on its ICPs, were allowable and correctly claimed
How OIG Did This Audit
We reviewed $2 million of Medicare pension costs that Cahaba CSA claimed for Medicare reimbursement on its ICPs for CYs 2014 through 2016.
What OIG Found
Cahaba CSA claimed pension costs of $2 million for Medicare reimbursement, through its ICPs, for CYs 2014 through 2016; however, we determined that the allowable Cost Accounting Standards-based pension costs during this period were $1.87 million. The difference, $127,002, represented unallowable Medicare pension costs that Cahaba CSA claimed on its ICPs for CYs 2014 through 2016. Cahaba CSA claimed these unallowable Medicare pension costs primarily because it based its claim for Medicare reimbursement on an incorrectly calculated allocable pension cost.
What OIG Recommends and Auditee Comments
We recommend that Cahaba CSA work with CMS to ensure that its final settlement of contract costs reflects a decrease in Medicare pension costs of $127,002 for CYs 2014 through 2016.
Cahaba CSA agreed with our recommendation to work with CMS to ensure that its final settlement of contract costs reflects a decrease in the Medicare pension costs of $127,002 for CYs 2014 through 2016. In addition, Cahaba CSA stated that it would ensure that future pension costs are claimed in accordance with the Medicare contracts.
Filed under: Centers for Medicare and Medicaid Services