HUSKY
Advocates ask CMS to intervene in HUSKY rate reductions
Two years ago, the state increased payment rates to providers in the Medicaid fee-for-service program and required that the HUSKY HMOs pay providers at least fee-for-service rates within the managed care program. The change in HMO contracts to require higher rates was included in the program’s federal waiver and capitation rates paid to plans were…
Read MoreFrom the consumer helpline: Medicaid consumers being charged
Two calls just this morning came from consumers covered by Medicaid being charged by hospitals. One was a mother on HUSKY Part A charged $281 by a hospital for services she already received. But the first call was from a man on Medicaid who was told by the hospital that they would not schedule the…
Read MoreHUSKY HMOs made $19 million profits last year; families paid $323.16 to HMO profits
At the very end of yesterday’s Medicaid Care Management Oversight Council meeting, DSS reported that the HUSKY HMOs made $18.8 million in profits on the program during 2009. This profit is on top of their administrative costs. Aetna made most of that profit — $14 million – despite having only one fourth of total enrollment.…
Read MoreConversion to risk corridors in HUSKY seems less likely
As reported by Christine Stuart at CT News Junkie, in a meeting yesterday the Executive Committee of the Medicaid Managed Care Council considered HUSKY financing options outlined by DSS at the last Council meeting. The budget passed earlier this year includes $76 million in savings to move HUSKY from the current capitated system to a…
Read MoreWill Charter Oak survive?
An interesting story by Arielle Levin Becker at the CT Mirror asks whether Charter Oak will survive after Governor Rell leaves office. The best thing about Charter Oak is that people with pre-existing conditions are not excluded from coverage; under national health reform, that exclusion will be prohibited in all health insurance in 2014. It…
Read MorePCCM/HUSKY Primary Care now on Facebook
The effort to move PCCM forward in Connecticut is taking a new turn – yes, we are joining Facebook! Type in “HUSKY Primary Care” on Facebook. The goal of this new group is to get people on or interested in HUSKY to talk about the exciting new option of PCCM/HUSKY Primary Care, with each other…
Read MoreDSS outlines options to move HUSKY away from capitation – or not
At yesterday’s Medicaid Care Management Oversight Council (formerly known as the Medicaid Managed Care Council), DSS outlined three policy options to restructure HUSKY’s financing. The options were a response to direction in the latest budget to move HUSKY from a fully insured, capitated system to a self-insured, ASO model; the budget included approximately $75 million…
Read More150,000 coming into already troubled Medicaid program
Finally attention is being paid to probably the largest impact of national reform – an estimated 150,000 people in CT will become eligible for Medicaid/HUSKY; an increase of 38% over current levels. Any reader of this blog knows how HUSKY has struggled since its inception. A secret shopper survey found only one in four listed…
Read MoreMedicaid Managed Care Council Update
First, at Friday’s meeting the Council decided to meet in August (on Friday the 13th) – we rarely do that – because of the many challenges and opportunities facing the program. At the meeting, DSS reported that they have sent a letter to CMS seeking guidance about how to move HUSKY from the current, controversial…
Read MoreMedicaid Managed Care Council update
Friday’s Council meeting focused mainly on plans for the $50 million temporary high risk pool opportunity created by national health reform. DSS joined the CT Insurance Dept. and the Health Reinsurance Association (HRA) to describe their plans. They intend to piggyback on the current high risk pool administered by HRA which was created in 1976…
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