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Fraud, Abuse, Or Retaliation
Where To Report Waste Fraud, Abuse, Or Retaliation
Recommendation Details
Text of Recommendation
We recommend that the Plan strengthen its internal controls over its capitation rate-setting process and create formal policies and procedures that document the methodology used to set the capitation rates.  The policies and procedures should clearly define how the rates are determined and define the criteria in which the rates can be adjusted. 
Recommendation Number
1
Recommendation Status
Closed
Significant Recommendation
No
Recommendation Questioned Costs
$0
Recommendation Funds for Better Use
$0