IHC Care, Inc. - Page 16




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          Part B (physician services) from petitioner’s network of                    
          providers, and petitioner was compensated by the Government for             
          each enrollee on a pre-paid, capitation basis.  Between 1993 and            
          1998, Group offered a Medicare “cost” health plan of the same               
          name.8                                                                      
               Petitioner and Group ceased offering their respective Senior           
          Care plans effective December 31, 1998.  Petitioner terminated              
          its Senior Care plan in part due to the financial losses that it            
          incurred under the program.                                                 
          C.  Enrollment                                                              
               As of September 30, 1997, petitioner had 22,258 enrollees,             
          including 15,006 enrollees in IHC Care and 7,252 enrollees in IHC           
          Senior Care.                                                                
          D.  Lack Of Free/Low Cost Services                                          
               Petitioner did not provide any charity care.  Petitioner did           
          not maintain a program designed to encourage or assist low income           
          persons, medically high-risk persons, persons located in                    
          medically under-served areas, or elderly persons to enroll in its           



          8    Under Group’s Senior Care plan, Medicare eligible enrollees            
          who paid the required premium were entitled to obtain physician             
          services (and a number of additional services not covered by                
          Medicare) from petitioner’s panel of primary care physicians and            
          specialists and were relieved of the obligation to pay any                  
          deductible or co-insurance payments under Medicare Part B                   
          (physician services).  Enrollees in Group’s Senior Care plan                
          retained their eligibility for Medicare Part A (hospital                    
          services) and continued to pay Medicare Part A premiums to the              
          Government.                                                                 





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