Department of Health and Human Services

Office of Inspector General -- AUDIT

"Calendar Year 2001 Adjusted Community Rate Proposal Modifications Under the Benefit Improvement Protection Act Submitted by Florida Health Care Plan, Holly Hill, Florida," (A-04-03-06017)

August 9, 2004

Complete Text of Report is available in PDF format (741 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


The objectives of this review were to determine whether Florida Health used the additional capitation payments in a manner consistent with the Benefits Improvement Protection Act (BIPA) requirements and (2) supported the modifications to the 2001 proposal.  About $1.2 million of the $6.9 million increase in Florida Health’s revised proposal was not used in a manner consistent with BIPA requirements or was not supported.  We recommended that Florida Health refund $1,247,220 to the Centers for Medicare & Medicaid Services or, as an alternative, deposit this amount in a benefit stabilization fund for use in future years.  We also recommended that Florida Health ensure that estimated costs in future proposals are properly supported.  Florida Health agreed with our recommendations.