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DSS and DCF report to the Behavioral Health Partnership Oversight Council December 13, 2006

DSS and DCF report to the Behavioral Health Partnership Oversight Council December 13, 2006. BH Carve-Out Financials. CT BHP Expenditures. First 8 months of CY2006 by date of payment; EDS claims only Separate expenditure reporting for HUSKY A and B Expenditures appear to have leveled off

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DSS and DCF report to the Behavioral Health Partnership Oversight Council December 13, 2006

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  1. DSS and DCF report to the Behavioral Health Partnership Oversight Council December 13, 2006

  2. BH Carve-Out Financials CT BHP Expenditures • First 8 months of CY2006 by date of payment; EDS claims only • Separate expenditure reporting for HUSKY A and B • Expenditures appear to have leveled off • Projected expenditures of approximately $102 million in SFY07

  3. Enhanced Care Clinics • 42 applications under review • Qualification Decision Date – December

  4. SFY07- Strategic Investment Options Proposed by DSS/DCF

  5. Observation Bed Rate Issues SFY07- Projected Fee Increase Expenditures

  6. Analysis of SFY07 Strategic Investment Options Requested by BHP OC Co-Chairs

  7. Observation Bed Rate Issues CT BHP Fee Increase AnalysisAcross the board

  8. CT BHP Fee Increase AnalysisGeneral Hospital IOP/PHP This analysis examines the financial impact of raising the minimum rate for IOP/PHP. Estimates are not final.

  9. CT BHP Fee Increase AnalysisFreestanding clinic IOP/PHP This analysis examines the financial impact of raising the minimum rate for IOP/PHP. Estimates are not final.

  10. CT BHP Fee Increase AnalysisIndependent Practitioners This analysis will examine the financial impact of raising fees for independent practitioners.

  11. CT BHP - Medicaid FFSCoverage Comparison

  12. CT BHP - Medicaid FFSCoverage Comparison

  13. Status of SFY07 BHP Rates CT BHP Claims Denial Rate • Average denial rate between 20-30% • Primarily the result of duplicate claims, TPL issues, need for authorization and timely filing requirements • FFS comparison under review, denial rate in FFS appears to be 30-40% • Pre-CT BHP denial rate under HUSKY unavailable

  14. Questions?

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