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State Health Plan audit released

Here is a link. I’ve just started but one of the first sentences says “We did not audit Blue Cross and Blue Shield of North Carolina administrative costs to determine if the costs were valid or reasonable.”

4 Comments

  1. Dumped on

    April 30, 2009 at 3:30 pm

    I read the Audit. What it does not include (and it should) is that the Administrator before the last one, ie (Jack Walker) left the plan in dire straits.
    Then they brought him back so he can point fingers at the last one.
    I would also think the auditors would be through enough to NOT address MR. Walker as (Dr.)
    I think they need to audit his application.

  2. Adam Linker

    April 30, 2009 at 3:36 pm

    Great point. No one every points out that Jack Walker ran the SHP into the ground several times before leaving.

  3. Dumped on

    April 30, 2009 at 9:40 pm

    Adam, I am new to the progressive pulse and NC Policy Watch. I discovered it when SEANC listed a link on thier site a few months ago.
    I have worked for the state for 14 years within the DOC. I am very appreciative of your information. Thank You for the work you are doing.
    Not all State Employees are bad and many are proud of the mission we carry out. It has been tough going for awhile now and I simply do not see light at the end of the tunnel.
    I don’t mind the furlough so much (hoping the next 2 months is all) but the State Health plan is going to really sting (I have Parent and children)
    Anyway if I sound crass and negative some I am sorry. Thanks again for your information.
    From dumped on disallusioned State Employee

  4. ananymous

    May 1, 2009 at 1:23 pm

    Valid and reasonable? During plan year 2007-2008, at the time the current shortfalls began, prior approval was required for anything over 24 mental health services annually. Even if you were lucky enough to get Value Options to approve necessary crisis care for a family member, BCBS’s computer systems automatically rejected mental health claims in spite of the valid prior approval. It was necessary to appeal each claim and have it processed by hand. At times it required three or four tries to get reimbursement of less than $50. Occasionally the subscriber received an additional pittance in interest because of the length of time to properly process the claim. Cost plus without transparency and oversight provides no incentive to correct this additional cost and burden to subscribers.

    Value Options and Medco should also be included in reform that brings proper oversight to the State Health Plan.