EmblemHealth unit overstated Medicare supplemental costs, OIG says

Group Health Inc., a subsidiary of EmblemHealth, overstated its supplemental executive retirement plan costs to Medicare, according to a report from HHS' Office of Inspector General.

CMS reimburses a portion of Medicare contractors' supplemental executive retirement plan costs. The OIG examined whether the supplemental executive retirement plan costs that Group Health reported from 2009-16 were allowable and correct. 

An audit of $874,007 supplemental executive retirement plan costs found that only $287,273 were allowable. The OIG said the overclaims were a result of Group Health not amortizing its lump-sum supplemental executive retirement plan payments.

In its response to the audit, Group Health said the OIG incorrectly incorporated ceiling rates in its analysis. The OIG maintained its findings.

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