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Department of Health and Human Services

Office of Inspector General -- AUDIT

"2004 Adjusted Community Rate Proposal Modifications Submitted as a Result of the Medicare Prescription Drug, Improvement, and Modernization Act," (A-04-05-06007)

December 21, 2005

Complete Text of Report is available in PDF format (453 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


The objective of our review was to determine whether WellCare of Florida, Inc.’s (WellCare’s) use of its Medicare Prescription Drug, Improvement, and Modernization Act (MMA) payment increase was adequately supported and allowable under MMA.  WellCare appropriately used the MMA payment increase to reduce beneficiary cost sharing for basic radiology services, to enhance over-the-counter drug benefits, to stabilize beneficiary access to providers through increased provider payments, and to cover the administrative costs of offering exclusive Medicare discount drug cards to plan members.  WellCare’s use of its increased MMA payments was adequately supported and allowable.  Therefore, we did not make any recommendations.