HOUSE COMMITTEE ON

AUDIT & HUMAN SERVICES BUDGET REFORM

 

 

March 18, 2003   Hearing Room 50

3:00 PM Tapes  61 - 62

 

MEMBERS PRESENT:            Rep. Ben Westlund, Chair

Rep. Steve March, Vice Chair

Rep. Jeff Kruse

Rep. Jeff Merkley

Rep. Alan Bates

 

MEMBERS EXCUSED:            Rep. Randy Miller

Rep. Susan Morgan, Vice-Chair

 

 

GUEST MEMBERS:               Rep. Mitch Greenlick

                                                Rep. Carolyn Tomei

                                                Rep. Gordon Anderson

 

STAFF PRESENT:                  Rick Berkobien, Committee Administrator

Kelly Fuller, Committee Assistant

 

ISSUES HEARD:                     Informational Meeting

                                                “Committee Discussion on OHP Recommendations”

 

 

These minutes are in compliance with Senate and House Rules.  Only text enclosed in quotation marks reports a speaker’s exact words.  For complete contents, please refer to the tapes.

 

TAPE/#

Speaker

Comments

TAPE, 61 A

001

Chair Westlund

Calls the meeting to order and opens the meeting for invited testimony and committee discussion.

INVITED TESTIMONY

015

Berkobien

Makes an announcement that item number eight on cost containment was incorrect on (EXHIBIT A) 3/17/03.  The Services Commission is looking at it, DHS isn’t currently calculating that item.  .Also gives recognitions to Lynn Read and her staff for the information on the cost containment report that helped with the final report from the Stakeholders group.

038

Chair Westlund

Comments that he has a meeting and has to leave at 4:45 pm.  Introduces Lynn Read Director of OMAP to help facilitated this committee discussion.

050

Lynn Read

Begins presentation to start the discussion.

111

Chair Westlund

Asks for a name of the provider discussed.

113

Rep. Kruse

Commented that Rocky King may have that information.

118

Read

Stated that that is where she got her information and her staff are researching the provider discussed to get further information.

144

Rep. March

Asks if that is diagnosis for diagnosis.

146

Read

Responds that it is for hospital stays and continues.

151

Rep. Greenlick

Asks if Lynn if she has that in days per thousand.

153

Read

Answers yes, and gives the information on the days per thousand

165

Chair Westlund

Asks for those figures again.

166

Read

Reads all the figures again.

170

Chair Westlund

Comments that you look at this in terms of cost containment this better leave fee for service out of Mental Health.

192

Rep. Greenlick

Comments that it was more expensive per person for fee for services, because each visit was 8 times more expensive.

200

Read

Responds and continues presentation.

244

Rep. Bates

Asks why this would not be capitated.

247

Read

Responds and continues.

251

Chair Westlund

Thinks this is an area we need to look at, asks if transport from the hospital after the stay is over considered an emergency.

261

Read

Responds no, unless someone would be going to a nursing facility under Medicare.

069

Chair Westlund

Relates his experience with an IPA, one is capitated on a fee for services basis and one is catch as catch can, and always debating rates.

296

Rep. Bates

The problem is there with this program and there has been stories about real abuse, but because it is paid for some people take advantage of it.  Why don’t we ask for a waiver from the Federal Government stating we are trying to get as much health care as possible and how much money do we spend each year on this service.

316

Read

State that yes, it is a significant amount and elaborates.

327

Rep. Bates

Comments that this is something we should look at, we are trying to buy back items for this group and this may be a place to look at seriously.

340

Read

It is a mandatory service for the OHP plus population, but that does not say it is not impossible to get a waiver in this area.

352

Rep. Greenlick

Says we should be careful with this, so we don’t have this use of rides taken away completely.

363

Read

Continues and talks about 3rd party administrators.

TAPE, 62 A

025

Berkobien

Asks what that 5 percent equates to roughly in dollars.

029

Read

Responds with percentage savings information.

044

Rep. Merkley

Asks if you pay for diabetic strips for OHP Plus patients.

048

Read

Responds yes.

051

Rep. Merkley

Shares a story from having breakfast with a continuant this morning.

083

Rep. Kruse

Comments about a contract with McKesson and would like some information.

088

Read

Responds yes, that information would be available and she will get that to us.  Continues presentation.

121

Rep. March

One of the problems noted was lack of social security numbers, is that correct.

125

Read

Responds about social security numbers and continues presentation.

130

Rep. Tomei

How many applications per day does your department receive.

135

Read

Responds that it is several thousand, but she did not bring that information with her.

145

Chair Westlund

Comment that the day they were there on their field trip it was 3300.

155

Read

Continues presentation.

217

Rep. March

You mention that the sight review are done annual, what are the results of those reviews.

225

Read

Comments about reviews and what comes out of that process.

235

Rep. March

Comments that it would be nice to have the person in charge of

255

Chair Westlund

How many FTE and what percent of OMAP budget and how many dollars that that represents, how much is that dedicated to the fee for service population.

265

Read

Will get that information to the committee by Thursday March 20, 2003.  Asks for some more details about the request.

282

Chair Westlund

Asks for information about how many savings can we get out of the departments if managed care takes over.

292

Rep. Greenlick

Asks Chair Westlund if he means how many FTE will go away.

300

Chair Westlund

Yes, but he wants it broken down and wants to know what those categories are.

330

Read

Ask if he wants information about administrative fees also.

337

Chair Westlund

Responds no, he does not want that.

345

Rep. March

Lets talk about FTE savings.

350

Read

Are you assuming the plan will pay for retroactive claims.

370

Chair Westlund

That hits the nail on the head, but we need that information to look at, asks if the plans take over that 90 day period of eligibility.

375

Read

Responds to the 90 day period of eligibility.

378

Chair Westlund

When an application comes in, and it is determined that that person can go into a managed care organization, there is no 90 day prior head for that person.

 

Read

Makes a comment about what happens when the application comes in.

TAPE, 61 B

001

Read

Makes comments on the scenario presented.

005

Chair Westlund

Makes additional comments for clarification

015

Rep. Tomei

Comments that even though that it is fee for service, you do not want to add this to the figures.

017

Read

Responds to the comments.

019

Rep. Greenlick

Comments that most plans will pay those if they get paid back.

021

Read

If all you are looking at is the processing, you can process them.

024

Rep. Bates

Wants to clear up some mis-conceptions on this conversation.  When someone comes in, asks if you are somehow separating these two groups.

036

Read

Responds and continues.

070

Rep. Bates

The real people potentially that will have difficulty with this 90 day period change, will be hospitals, and elaborates.

091

Read

Responds yes, and continues.

110

Chair Westlund

Asks what can we do as a legislature help you as a department function better, perform more efficiently.

118

Rep. Greenlick

Comments that maybe the agency can function very efficiently, but congress is getting in the way.

121

Read

Makes additional comments.

130

Chair Westlund

If you can get us some bullet points on that prioritized that would be great.

150

Rep. Greenlick

That was a good issue she raised and would like some follow up on that.

160

Read

Responds that some of that is issues from that Federal Government and elaborates.

170

Rep. March

We did not suggest that they go through one door, but we do not want to go the other way either.

175

Read

Responds that there are a lot of advantages of what is being looked at as far as the needs of individuals.

178

Chair Westlund

Appreciates Rep. Greenlick’s comments.

187

Rep. Bates

Is it allowable by Federal law for the plans to do eligibility themselves.

196

Read

Will look into that.

198

Chair Westlund

Asks Jeff Heatherington in the audience if he knew the answer.

204

Jeff Heatherington

Responds.

208

Chair Westlund

Comments that they appreciate all that Lynn and staff are doing over there.

212

Rep. March

Asks if there are any questions we should be asking of them.

226

Read

She will get back to us on that.

230

Chair Westlund

We have a daunting task ahead of us, lets talk to each other.

236

Rep. Bates

Asks about the report to be given to the sub committee on ways and means.

245

Chair Westlund

Comments on the form of the report.

 

 

Calls meeting to a close and adjourns 4:35pm

 

 

 

EXHIBIT SUMMARY

 

A – NONE