Audit of Cooperativa De Seguros De Vida De Puerto Rico's Final Administrative Cost Proposal for Fiscal Years 2005 through 2007

摘要

CMS contracts provide for the reimbursement of allowable administrative costs incurred in processing Medicare claims. In claiming costs, contractors must follow cost reimbursement principles contained in the Federal Acquisition Regulation (FAR) and the Medicare contracts. Following the close of each fiscal year (FY), contractors submit to CMS a Final Administrative Cost Proposal (cost proposal), which reports the Medicare administrative costs incurred during the year. The cost proposal and supporting data provide the basis for the CMS contracting officer and contractor to negotiate a final settlement of allowable administrative costs. For FYs 2005 through 2007, CMS contracted with Cooperativa de Seguros de Vida de Puerto Rico (COSVI) to serve as the Part A fiscal intermediary for the Commonwealth of Puerto Rico and the United States Virgin Islands. COSVI reported Medicare Part A administrative costs totaling 10,327,220 in its cost proposals for FYs 2005 through 2007. Our objectives were to determine whether (1) the COSVI cost proposals fairly presented program administration costs and (2) the costs were reasonable, allowable, and allocable in accordance with the FAR and the Medicare contracts.