Heathcare policy & Benefit services division header

Healthcare Cost Containment Committee Minutes
March 5, 2012

Meeting Called to order by Tom

New Business:
1) Experience and budget report
- E mail Karen full file

2) Dependant Audit
- Have online tool available at OE to establish types
- Positive Enrollment?
- Use online affidavit for those hired prior to 2008
- Period of Amnesty? No, they can drop at OE with no COBRA but discipline still stays

3) Tabled
- Possible OSC Notification to high $ prescribers – docs - for notice of generic/brand name

4) HEP Compliance
- April Notification – w/info available to date
- Calendar year compliance
- On-line self reporting / affidavit approach

5) Pooling – 50 Inquiries
- Working on marketing tools
- Small group will be manually rated
- Requesting a report of town by town status on a weekly basis

6) CCMC & Anthem terming contract
- Currently no insight into outlook
- Looking to tell then they will have to be treated as “in-network”
- Currently w/in 30 day notification window
- Would include satellite offices

Vox Populi
- COPD Chronic Care – lists 3 meds they should take? Anthem?
- Orthonet denying physical therapy – can we have Anthem reach out to the provider?
- Requesting NCQA code listings for chronic conditions – especially diabetes, hypertension, and hyperlidemia
- What drugs are maintenance; which are not?
- What is update on 20% refund for dental cleanings?
- ER Form – claim will have to come from hospital
- Will carrier get a new EOB?

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