Inspector General Open Recommendations
1
We recommend that the contracting officer require the Plan to return $3,198,939 to the FEHBP for the questioned IHS claim overpayments that were considered uncollectible by the Plan, whether recovered or not, as prompt and diligent efforts to recover, including provider offsets (voucher deductions), were not made timely. However, since we verified that the Plan subsequently returned $676,319 of these questioned claim overpayments to the FEHBP, the contracting officer only needs to ensure that the Plan returns the remaining questioned overpayments of $2,522,620 to the FEHBP. (Note: We believe that these questioned IHS claim overpayments of $500 or more should be reasonable and very cost effective to recover via provider offsets by the Plan.)
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