NYSPA Insurance Committee Town Hall Meeting MVP / ValueOptions Network Mailings

1. NYSPA Insurance CommitteeTown Hall MeetingMVP / ValueOptions Network Mailings Webinar - https://www2.gotomeeting.com/register/429764354 Friday August 4th 2009 9 am – 10 am EST

2. Agenda • Introduction / Overview of call • MVP / ValueOptions provider letter review • Contract Language • Fee Schedule definitions • Next Steps – Psychologist Actions • Question and Answers

3. Provider letter overview • ValueOptions mailed to provider network in phases and identified their mailing according to the status of providers either already in network or out of network for ValueOptions and / or in network or out of network for MVP. • ValueOptions mailings are virtually identical to one another. The difference between the IPA Agreement and the VO Agreement are sections that are deleted in the VO Agreement in order to have required language by the New York IPA, Medicaid and by federal government for Medicare Advantage Plans.

4. Sample of Provider Letter

5. Contract Language • CHCS – “CHCS IPA” ValueOptions acts as the management contractor for MVP and to be able to contract in New York for MVP. CHCS is really ValueOptions for this contract. • Addendum – Modification of the provider services agreement previously executed between provider and ValueOptions. • MVP Assignment – MVP has “loaned” some of its regional network to ValueOptions for the term of this agreement. If agreement between MVP and ValueOptions terminates and/or ends, those assigned providers go back to MVP. These assigned providers are not technically a part of the ValueOptions network for the MVP book of business. • Objection – Meaning you do not want to participate in either the Addendum or the CHCS Provider Services Agreement.

6. Fee Schedule Definitions CHCS IPA Inc. New York State Medicaid and Medicare Fee Schedule This is the fee schedule if you are currently seeing any Managed Medicare or Medicaid patients through ValueOptions. IF you already have other rates that you have negotiated with ValueOptions you will need to send those rates to: ValueOptions Provider Relations 433 River Street Troy, New York 12081 this assures the negotiated fees are loaded correctly. These rates do not include MVP managed Medicare and Medicaid.

7. Fee Schedule cont. ValueOptions Inc. MVP Health Care Professional Fee Schedule These are the new rates proposed for the MVP network administered by ValueOptions. If you received a mailing in June from MVP regarding your rate, that rate is what you will be paid. If you did not receive a mailing from MVP in June and you received your rates from ValueOptions, those are the rates contracted for your MVP patients.

8. Fee Schedule cont. ValueOptions Inc. New York HMO Professional Fee Schedule This fee schedule is for any new regional HMO business that ValueOptions MAY retain in the future ( ex. CDPHP, GHI- HMO) but it is not a functioning fee schedule to date.

9. Next Steps – Psychologists Actions • You the provider can object to any or part of this mailing. If you object you must be specific in your objection, place in writing what you are objecting to and the line of business to which it pertains and send objection letter to address stated in your provider letter. • If you have rates already established for any other Managed Medicaid or Medicare managed through ValueOptions you need to send a letter stating you are not accepting the new fee schedule and include your negotiated rates. These letters need to go to Provider Relations located in Troy, New York • If you agree to the CHCS IPA Provider Service Agreement you must complete and sign the execution page and send back to address stated. • If you do not object to the Addendum portion of the agreement you will automatically be placed into the MVP and NY HMO networks and given the fee schedules mailed to you • Please note that you the provider can negotiate your fees, if you do not agree, you can request a negotiation with Cathy Gilbert, National Director of Provider Relations located at the Troy, New York address. • In making contracting decisions, please weigh each cost and benefit as it affects your practice and business and decide what is best for you.

10. Contact Information • Call (800) 235 – 3149 and ask to speak to Troy Provider Relations for any contracting inquiries or for general questions regarding your network status and fee schedules.

11. Questions and Answers

12. Thank You Please fill out the on line program evaluation