Healthcare Cost Containment Committee Meeting Minutes
Meeting called to order by Tom Woodruff
- 1) PT/OT Implementation - Anthemís Medical Director discussed the
clinical review process for PT/OT prior to 10/1/11 and after 10/1/11. United
Healthcare/Oxford confirmed. Medicare standards applied after 12/1/11.
Anthem reported overall approval rating for services to be at 94.5%. Oxford
had 835 members request service; was not able to provide overall approval
2) HEP Compliance Update - Anthem and Oxford provided update on status of
- a. Anthem - 68,256 members reviewed; 25,000 compliance letters sent
to employees; 23,166 non-compliance letters sent to individuals.
b. Oxford - 10,509 members reviewed; 3,961 compliance letters sent
employees; 4,880 non-compliance letters sent to individuals
- 3) Open Enrollment - OSC staff attending all open enrollment fairs
throughout the State.
4) Financial Report - Rae-Ellen provided budget report to the Committee.
Milliman presented experience report.
5) Dependent Eligibility - Peggy provided update on OLM clarifications and
draft of HCPBSD memo regarding the process.
6) OPEB Report - Tom noted that the we should have the final report later in
Vox Populi - Review of impact to Partnership Plan if non-profit organizations
joined the plan.
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