Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review of Medicare Prescription Drug, Improvement, and Modernization Act Modifications to Calendar Year 2004 Proposal - Horizon Healthcare of New Jersey, Inc.," (A-02-05-01015)

May 24, 2006


Complete Text of Report is available in PDF format (176 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


EXECUTIVE SUMMARY:

The objective of our review was to determine whether Horizon Healthcare of New Jersey, Inc.ís (Horizonís) use of its MMA payment increase was adequately supported and allowable under MMA.  Horizonís use of its MMA payment increase was adequately supported and allowable under the MMA.  Horizon appropriately used the increased Medicare capitation payments to reduce beneficiary premiums, enhance benefits, and stabilize and enhance beneficiary access to providers.  Specifically, Horizon eliminated beneficiary premiums, enhanced benefits by adding vision and prescription benefits, and increased capitation payments to primary care providers.  Therefore, we did not make any recommendations.