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Healthcare Cost Containment Committee Meeting Minutes
May 2012

Meeting called to order by Tom Woodruff

1) PT/OT Implementation - Anthem?s 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 rate.
2) HEP Compliance Update - Anthem and Oxford provided update on status of HEP compliance:
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 the month.

Vox Populi - Review of impact to Partnership Plan if non-profit organizations joined the plan.

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