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The audit of large rate increases granted to the HUSKY HMOs last year has been released. Accounting firm Milliman found that the state overpaid the HMOs between $41 and 39 million. The Governor has already incorporated over $50 million in savings from re-negotiating HMO rates based on this report in her latest budget proposal. The audit also raised concerns about the soundness of rate setting practices and assumptions including trend adjustments, data re-basing, guarding against double-counting, and incomplete documentation. The report summary includes concerns about lack of transparency and accountability; the entire $4 billion Medical budget is included in only one line item. Advocates argue that the $50 million in savings can be used to avert cuts to HUSKY families including copays, dental care, medical interpretation, medical necessity, and elimination of coverage for immigrants. The funding could also be used to improve health care in CT by covering smoking cessation in HUSKY, improving primary care rates, providing incentives for quality care, or removing the onerous requirement that Charter Oak Health Plan applicants be uninsured for six months or pay one third of their incomes on insurance.
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Ellen Andrews