Review of Health Maintenance Organization Controls Over Durable Medical Equipment Suppliers in Florida

Humana Medical Plan, Inc. (Humana) in Florida had established adequate controls to ensure that Durable Medical Equipment (DME) services were adequately supported and that beneficiaries received the DME paid for through its Health Maintenance Organization plan in Miami-Dade and Broward counties during January 1, 2008, through December 31, 2009. During this period, Humana had a capitation contract with only one DME supplier, who spent over 43 percent of Humana's total statewide costs for DME supplies in Miami-Dade and Broward counties alone. We are not offering any recommendations to Humana in this audit report.