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HRD-79-116 1 (1979-09-10)

handle is hein.gao/gaobaaztu0001 and id is 1 raw text is: 
RELEASED


SEPTEMBER 10, 1979


B-164031(3)


The Honorable Sam M. Gibbons
Chairman, Subcommittee on Oversight
Committee on Ways and Means
House of Representatives          o

Dear Mr. Chairman:

     Subject: LBlue Cross Association Performance
               as a Medicare Contractor (HRD-79-116)

     Your March 1, 1979, letter (and attachments) requested
that we examine (1) potential future roles for the Blue Cross&6Lb
Association (BCA) as a Medicare intermediary under contract
with the Department of Health, Education, and Welfare (HEW  ccnc 2-
and (2) certain aspects of BCA's past performance as the
prime contractor for the 68 Blue Cross plans acting as
Medicare intermediaries.

     Because of the particular concern you expressed over the
adequacy of BCA's performance, this report deals exclusively
with that issue. Alternative roles for BCA as a Medicare
intermediary will be discussed in a separate report to you,
which we currently expect to complete early in 1980.

     The concern over BCA's performance centers on its role
in and implementation of Medicare reimbursement policy for
the fees charged to Medicare home health agencies by the Z     -
Unihealth Services Corporation, Inc., of New Orleans. As
you know, we testified on Unihealth's activities before your
Subcommittee in August 1978, and subsequently, information
was developed by the Subcommittee that suggested BCA may have
delayed or interfered with the implementation of Medicare's
policy on the allowability of Unihealth charges for reim-
bursement purposes.

                                                     (106171)


9271


HUMAN RESOURCES
   DIVISION


110541


UNITED STATES GENERAL ACCOUNTING OFFICE


        WASHINGTON, D.C. 20548


//045(t/


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