2004 Adjusted Community Rate Proposal Modifications Submitted as a Result of the Medicare Prescription Drug, Improvement, and Modernization Act

EXECUTIVE SUMMARY:

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.