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Health Care

October 26, 1995| Times Staff and Wire Reports

Medicare, Blue Cross Resolve Claims Dispute: The nation's Blue Cross plans have agreed to a $115-million settlement of a dispute with the government over Medicare payments of health claims for the working elderly who have private insurance. The Justice Department said 67 Blue Cross and Blue Shield plans will pay $27 million in cash and drop demands for $88 million in funds they had already repaid Medicare. Under the settlement, the plans will also furnish information to the Health Care Financing Administration, which runs Medicare, for three years to help it avoid mistaken payments. By law, Medicare is the secondary payer for workers 65 and older who have private insurance through their jobs and the secondary payer for their spouses. But the government has had difficulty keeping track of which senior citizens are still working. The companies admitted no wrongdoing or liability. The 67 Blue Cross plans will also help the government identify hospitals and other health care providers that were paid twice for the same claim.

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