DOCSLIB.ORG

HCR 2 Medicaid Expansion Enrollment and Claims Data SFY 21 Q1HCR 2

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
HCR 2 Medicaid Expansion Enrollment and Claims Data SFY 21 Q1HCR 2 John Bel Edwards Dr. Courtney N. Phillips GOVERNOR SECRETARY State of Louisiana Louisiana Department of Health Office of the Secretary January 29, 2021 The Honorable John Bel Edwards, Governor State of Louisiana P.O. Box 94004 Baton Rouge, LA 70804 The Honorable Patrick Page Cortez, President Louisiana State Senate P.O. Box 94183, Capitol Station Baton Rouge, LA 70804-9183 The Honorable Clay Schexnayder, Speaker Louisiana State House of Representatives P.O. Box 94062, Capitol Station Baton Rouge, LA 70804-9062 Re: HCR 2 Quarterly Report SFY 21 Q1 - Medicaid Assessment Report In response to House Concurrent Resolution 2 (HCR 2) of the 2020 First Extraordinary Session, the Louisiana Department of Health (LDH) submits the enclosed report. This report can be viewed on LDH’s website at https://ldh.la.gov/index.cfm/newsroom/detail/5892 the resolution requires LDH to publish on a quarterly basis a report containing data directly related to payment for health care services through the implementation of a health coverage expansion of the Louisiana medical assistance program. The report includes the following: (a) Total Medicaid Expansion enrollment on a monthly basis from July 2020 through September 2020. (b) The average monthly Expansion premium paid to managed care organizations providing benefits and services to eligible Medicaid enrollees and the portion of the premium related to hospital payments for the July 1, 2020 rates. (c) The aggregate Medicaid Expansion claims payment by provider type for July 2020 through September 2020. (d) The total amount of inpatient and outpatient Medicaid Expansion claims paid to hospitals delineated by individual hospital for July Bienville Building ▪ 628 N. Fourth St. ▪ P.O. Box 629 ▪ Baton Rouge, Louisiana 70821-0629 Phone: (225) 342-9500 ▪ Fax: (225) 342-5568 ▪ www.dhh.la.gov An Equal Opportunity Employer The Honorable John Bel Edwards The Honorable Patrick “Page” Cortez The Honorable Clay Schexnayder HCR 2 Quarterly Report January 19, 2021 Page 2 2020 through September 2020 separated into two attachments by inpatient and outpatient. Please feel free to contact me at (225) 342-6726 with any questions or comments that you may have regarding the enclosed report. Sincerely, Ruth Johnson Undersecretary Enclosure cc: The Honorable Senator Fred H. Mills, Senator The Honorable Mack “Bodi” White, Senator The Honorable Larry Bagley, Representative The Honorable Jerome “Zee” Zeringue, Representative Mr. David R. Poynter, Legislative Research Library (A) Total Medicaid Expansion enrollment on a monthly basis. Month Enrollees July 2020 538,114 August 2020 550,576 September 2020 562,374 Source: LAMEDS, Enrollment Trends Report http://www.ldh.la.gov/index.cfm/page/1275. Data is extracted on or near the 1st day following the end of each month. Monthly data is not updated in subsequent months to reflect retro eligibility determinations made after the end of each month. HCR2_SFY2021_Q1 Business Analytics 1 of 43 (B) Average Per Member Per Month and Portion of the Per Member Per Month Associated with Hospitals Expansion Rate Estimate -- Rate Floor Expansion Adult (Rate Floor) Hospital Portion of Expansion Rate Full Rate $590.74 $254.91 • Hospital records are identified by CLQ_Claim_Type 01 and 03. • The PMPM above does not include claims related to maternity kick payments. • The PMPM above is the aggregate rate for regular Expansion rate cells (which do not include SBH/NEMT-only and High Needs rate cells). HCR2_SFY2021_Q1 Mercer Report 2 of 43 (C) The aggregate M edicaid claims payment by provider type (for Expansion only). NOTE: 1) Data are based on service provider types. 2) Data extracted by DOP and on 10/14/2020. 3) Error Providers are made up of those providers that are enrolled in the Managed Care Program but not enrolled in the Fee For Service Program (FFS). 4) Methodology change effective 7/1/19 for HCR 5 removing PMPM payments to MCOs and MCNA (Provider Types 05 & AY) to eliminate duplication of total dollars reported. 5) Provider Types 60, 64 & 69 include $653,175 in payments for Non-Inpatient/Non-Outpatient claim types. Provider Type Description for Provider Type Total (= FFS + Encounters) Provider Jul-2020 Aug-2020 Sep-2020 SFY Sum Type Total $ 247,222,166 $ 248,418,800 $ 229,152,618 $ 724,793,584 Total 03 CHILDREN'S CHOICE (WVR)(IN-ST) 1,105 1,079 5,955 8,139 03 04 PEDI DAY HLTH CARE (IN-ST) 3,188 107 3,295 04 06 NOW PROFESSIONAL SERVICES 12,081 13,503 11,353 36,937 06 07 CASE MGMT-INFT & TODD (IN-ST) 42,691 92,613 31,795 167,099 07 08 OAAS CASE MGMT (IN-ST) 2,159 1,847 4,007 08 09 HOSPICE SERVICES (IN-ST) 276,144 178,578 270,799 725,521 09 12 MULTI-SYSTEMIC THER (IN-ST) 2,217 1,416 1,520 5,154 12 13 PREVOC REHAB (WVR) (IN-ST) 89 540 379 1,008 13 16 PERS EMERG RESP SYS (WVR) 4,545 4,732 5,822 15,099 16 18 COMM MENTAL HLTH CTR/PART HOSP 329,905 70,725 22,904 423,533 18 19 DR OF OSTEOPATH MED (IND & GP) 820,895 1,010,575 750,496 2,581,966 19 20 PHYSICIAN (IND & GP) 28,201,736 33,631,693 25,819,934 87,653,363 20 23 INDEPENDENT LAB 4,417,012 5,483,103 3,790,879 13,690,994 23 24 PERSONAL CARE SERVICES (IN-ST) 279,199 302,783 355,741 937,722 24 25 MOBILE XRAY/RADIATION THRPY CT 15,420 18,859 14,338 48,618 25 26 PHARMACY 79,227,642 72,138,567 78,669,611 230,035,820 26 27 DENTIST (IND & GP) 2,454,491 2,044,557 1,778,495 6,277,544 27 28 OPTOMETRIST (IND & GP) 1,264,799 1,202,442 1,151,115 3,618,356 28 29 EARLYSTEPS (IND & GP) (IN-ST) 5 6 11 29 30 CHIROPRACTOR (IND & GP) 37,680 39,587 30,026 107,292 30 31 PSYCHOLOGIST (LIC/MED) (IN-ST) 135,345 133,680 81,265 350,291 31 32 PODIATRIST (IND & GP) 178,470 236,889 204,476 619,835 32 33 PRESCRIBING ONLY PROVIDER 161,207 120,218 38,237 319,662 33 34 AUDIOLOGIST (IN-ST) 14,733 14,131 13,903 42,768 34 35 PHYSICAL THERAPIST (IN-ST) 430,591 520,755 414,082 1,365,428 35 37 OCCUPATIONAL THERAPIST (IN-ST) 41,795 47,954 34,025 123,774 37 38 SCHOOL BSED HEALTH CTR (IN-ST) 363 88 58 509 38 39 SPEECH/LANGUAGE THERAP (IN-ST) 10,868 7,735 7,395 25,998 39 40 DME 2,485,374 2,472,921 2,320,557 7,278,851 40 41 REGISTERED DIETICIAN (IN-ST) 5,885 7,529 4,975 18,389 41 HCR2_SFY2021_Q1 Business Analytics 3 of 43 Provider Type Description for Provider Type Total (= FFS + Encounters) Provider Jul-2020 Aug-2020 Sep-2020 SFY Sum Type 42 NON-EMER MED TRANSPORT (IN-ST) 587,367 536,053 331,669 1,455,090 42 43 CASE MGT - NHV/FTM (IN-ST) 2,774 6,028 5,441 14,244 43 44 HOME HEALTH AGENCY (IN-ST) 708,122 1,007,568 827,681 2,543,372 44 45 CASE MGMT - CONTRACTOR (IN-ST) 1,459 1,761 570 3,791 45 47 CASE MGMT - CMI 18,065 15,830 11,034 44,929 47 51 AMBULANCE TRANSPORTATION 2,620,022 2,303,420 2,023,196 6,946,637 51 54 AMBULATORY SURGI CTR (IN-ST) 110,872 133,260 104,222 348,353 54 55 EMERG ACCESS HOSPITAL (IN-ST) 7,395 11,531 14,628 33,555 55 56 PRESCRIBER ONLY FOR MCO 4,164 3,813 3,742 11,719 56 57 OPH REGISTERED NURSE (IN-ST) 7,968 14,428 16,379 38,775 57 59 NEURO REHAB HOSPITAL (IN-ST) 128,851 118,348 203,018 450,217 59 60 HOSPITAL 89,057,034 89,556,871 79,342,800 257,956,704 60 61 VENERIAL DISEASE CL (IN-ST) 10,260 10,588 3,058 23,905 61 62 TUBERCULOSIS CLINIC 446 430 876 62 64 MENTAL HLTH HOSP (FREE-STAND) 7,637,505 8,225,441 7,184,293 23,047,238 64 65 REHABILITATION CENTER (IN-ST) 49,193 47,338 12,584 109,115 65 66 KIDMED SCREENING CLINIC 16,231 12,682 1,468 30,381 66 67 PRENATAL HLTH CARE CL (IN-ST) 2,800 2,420 5,442 10,662 67 68 SUBS/ALCOH ABSE CTR (X-OVERS) 1,165,723 1,318,826 1,316,985 3,801,534 68 69 DIST PART PSYCH HOSP (IN-ST) 2,996,048 2,585,946 2,315,690 7,897,684 69 70 EPSDT HEALTH SERVICES (IN-ST) 27,020 10,868 10 37,898 70 71 FMLY PLANNING CLINIC (IN-ST) 12,265 5,221 11 17,497 71 72 FED QUALIFIED HLTH CTR (IN-ST) 256,005 337,772 183,692 777,470 72 73 LIC CL SOCIAL WORKER (IN-ST) 860,286 928,771 614,165 2,403,221 73 74 MENTAL HEALTH CLINIC (IN-ST) 92,848 41,757 35,448 170,053 74 75 OPTICAL SUPPLIER 44,038 50,781 48,552 143,371 75 76 HEMODIALYSIS CENTER (IN-ST) 647,020 644,692 598,288 1,890,000 76 77 MENTAL REHAB AGENCY (IN-ST) 399,558 438,911 413,908 1,252,377 77 78 NURSE PRACTITIONER (IND & GP) 6,183,381 7,565,048 5,716,048 19,464,476 78 79 RURAL HLTH CL(PROV-BSE)(IN-ST) 142,722 133,330 70,510 346,562 79 80 NURSING FACILITY (IN-ST) 718,433 504,482 753,074 1,975,989 80 81 CASE MGMT - VENT ASSTD CARE 1,703 1,703 81 82 PERS CARE ATTEND (WVR) (IN-ST) 43 43 82 84 SUBSTIT FMLY CARE (WVR)(IN-ST) 864 1,283 1,241 3,387 84 87 RURAL HLTH CL(INDEPEND)(IN-ST) 36,381 53,744 21,879 112,005 87 90 CERTIFIED NURSE MIDWIFE 48,610 60,420 45,048 154,079 90 91 CERT REG NURS ANEST (IND & GP) 851,155 930,641 879,592 2,661,388 91 93 CLINICAL NURSE SPECIALIST 26,101 32,168 31,065 89,333 93 94 PHYSICIAN ASSISTANT 1,002,666 1,177,772 896,984 3,077,422 94 HCR2_SFY2021_Q1 Business Analytics 4 of 43 Provider Type Description for Provider Type Total (= FFS + Encounters) Provider Jul-2020 Aug-2020 Sep-2020 SFY Sum Type 96 PSYCH RESID TREAT FACILITY 91,362 17,709 3,417 112,488 96 AA ASSERTIVE COMM TREAT TEAM 222,354 192,315 174,675 589,344 AA AD TRANSITION COORDINATION 125 125 AD AF CRISIS RECEIVING CENTER 4,496 2,540 6,140 13,175 AF AG BEHAVIORAL HLTH REHAB AGENCY 503,694 349,849 554,067 1,407,610 AG AH LIC MARRIAGE & FAMILY THERAPY 23,157 27,365 21,833 72,355 AH AJ LICENSED ADDICTION COUNSELOR 68,461 85,565 52,188 206,215 AJ AK LICENSED PROFESSION COUNSELOR 958,874 1,072,773 801,552 2,833,199 AK AL COMMUNITY CHOICE WAIVER-NURS 1,226 528 1,754 AL AS OPH CLINIC 2,458 7,985 6,207 16,650 AS AT THERAPEUTIC GROUP HOME 60,082 45,054 76,847 181,983 AT AU OPH REGISTERED DIETITIAN 9 9 AU AW PERMANENT SUPPOR HOUSING AGENT 42,900 6,367 4,400 53,667 AW AZ SUBST USE RESIDENT TX FAC 4,941,177 5,178,206 4,952,059 15,071,441 AZ MW LICENSED MID-WIFE 11,564 17,397 14,436 43,397 MW NB NON-LICENSED BEHAVIORAL HEALTH STAFF 2,243,747 2,197,423 1,862,886 6,304,056 NB PO OPR (ORDERING, PRESCRIBING, AND REFERRING) 24,158 21,451 7,636 53,245 PO TM TRANSPORTATION MANAGEMENT CONTRACTOR 669 883 1,983 3,535 TM TS TRANSPORTATION SUBCONTRACTOR 55,749 1,559 18 57,326 TS WA WRAP AROUND AGENCY 1,338 4,845 1,121 7,304 WA XX ERROR PROVIDER 625,293 557,774 747,606 1,930,673 XX HCR2_SFY2021_Q1 Business Analytics 5 of 43 (D.1) The total amount of inpatient M edicaid claims paid to hospitals delineated by individual hospital (for Expansion only).
Load more

Recommended publications
  • Exhibit #2 Base Rates and Cost-To-Charge Ratios Source: Medicare FY 2019 IPPS Impact File - Correction Notice (September 2018) Effective 1/1/2020
    Exhibit #2 Base Rates and Cost-to-Charge Ratios Source: Medicare FY 2019 IPPS Impact File - Correction Notice (September 2018) Effective 1/1/2020 Provider Total Individual Hospital Name Number CCR Base Rate 060001 North Colorado Medical Center 0.268 $6,930.02 060003 Longmont United Hospital 0.323 $6,416.24 060004 Platte Valley Medical Center 0.420 $6,296.29 060006 Montrose Memorial Hospital 0.404 $6,250.18 060008 San Luis Valley Health 0.386 $6,250.18 060009 Lutheran Medical Center 0.235 $6,370.99 060010 Poudre Valley Hospital 0.302 $6,499.23 060011 Denver Health Medical Center 0.324 $8,185.33 060012 Centura Health-St Mary Corwin Medical Center 0.229 $6,818.43 060013 Mercy Regional Medical Center 0.287 $8,029.28 060014 Presbyterian St Lukes Medical Center 0.154 $6,905.48 060015 Centura Health-St Anthony Hospital 0.205 $6,365.32 060020 Parkview Medical Center Inc 0.164 $6,901.98 060022 University Colo Health Memorial Hospital Central 0.221 $6,426.00 060023 St Mary’s Medical Center 0.308 $6,994.17 060024 University Of Colorado Hospital Authority 0.169 $7,902.58 060027 Foothills Hospital 0.218 $6,312.83 060028 Saint Joseph Hospital 0.196 $7,001.47 060030 Mckee Medical Center 0.366 $6,362.47 060031 Centura Health-Penrose St Francis Health Services 0.212 $6,387.05 060032 Rose Medical Center 0.136 $6,735.37 060034 Swedish Medical Center 0.120 $6,539.19 060044 Colorado Plains Medical Center 0.264 $6,621.20 060049 Uchealth Yampa Valley Medical Center 0.539 $9,490.44 060054 Community Hospital 0.322 $6,242.53 060064 Centura Health-Porter Adventist
    [Show full text]
  • Town of Vail
    TOWN OF VAIL TURNING YOUR FEEDBACK INTO ACTION Focusing on Housing for Local Families Making Progress with Parking & Transportation Taking a Leadership Role in Sustainability Financial & Department Updates THE DAVIS FAMILY New homeowners at Chamonix Vail in West Vail Building on In the pages that follow, learn what the Vail Town Council, Board your Feedback and Commission members, town staff and agency partners have been doing to involve the community in: 2017 was the year for listening, focus • Providing additional housing opportunities for local residents and action. With information gathered • Making it easier to get around town from the biennial community survey • Becoming a leader in our environmental sustainability practices coupled with ongoing outreach, including online forums and involvement from • Enhancing neighborhood amenities all corners of the community, considerable • Advancing Vail’s appeal as the premier international mountain progress was made in the focus areas of ECONOMY, COMMUNITY and EXPERIENCE. resort community Together, these initiatives are keeping Vail in a leadership position as the Premier Lastly, we’re pleased to celebrate the talents and contributions of International Mountain Resort Community. the people who have come together to make Vail a special place. 2017 MILESTONES JANUARY FEBRUARY MARCH APRIL MAY JUNE Jan 16 Feb 21 March 7 April 1 May 4 June 3 Community members invited Re-dedication of newly-renovated Life-Saving Recognition Awards Online citizen portal launched Year-round safe disposal Launch of
    [Show full text]
  • FY 2020 Proposed Rule Impact File.Xlsx
    Projected Impact of FY2020 IPPS Rule FY 2020 IPPS Impact File ‐ Proposed Rule (April 2019) Average Provider Name Beds Daily Bills CMIV36 CMIV37 ∆CMI ∆ % ∆ $ Number Census 060107 National Jewish Health 24 0 2 1.5158 1.1036 ‐0.4122 ‐27.2%$ (6,595) 050547 Sonoma Developmental Center 13 4 37 1.0893 0.9338 ‐0.1555 ‐14.3% $ (46,028) 450831 Surgery Specialty Hospitals Of America Se Houston 37 0 31 2.8662 2.4739 ‐0.3923 ‐13.7%$ (97,290) 320038 Rehoboth Mckinley Christian Health Care Services 60 21 861 1.471 1.3177 ‐0.1533 ‐10.4%$ (1,055,930) 150149 Women's Hospital The 74 44 31 1.582 1.4228 ‐0.1592 ‐10.1%$ (39,482) 400022 Hospital Damas Inc 209 139 636 1.781 1.6172 ‐0.1638 ‐9.2%$ (833,414) 240206 Red Lake Hospital A 23 4 8 0.9597 0.875 ‐0.0847 ‐8.8%$ (5,421) 240196 Phillips Eye Institute 8 0 3 1.3739 1.2583 ‐0.1156 ‐8.4%$ (2,774) 260085 St Joseph Medical Center 173 104 2870 1.8602 1.7196 ‐0.1406 ‐7.6%$ (3,228,176) 400122 Professional Hospital Guaynabo Inc 54 13 122 2.1536 2.0007 ‐0.1529 ‐7.1%$ (149,230) 330086 Montefiore Mount Vernon Hospital 63 45 706 1.4516 1.3537 ‐0.0979 ‐6.7%$ (552,939) 050030 Oroville Hospital 133 113 6052 1.5656 1.4648 ‐0.1008 ‐6.4%$ (4,880,333) 460043 Orem Community Hospital 18 6 4 1.7712 1.6588 ‐0.1124 ‐6.3%$ (3,597) 320060 Zuni Comprehensive Community Health Center 27 5 131 1.1353 1.0647 ‐0.0706 ‐6.2%$ (73,989) 250134 Whitfield Medical Surgical Hospital 32 4 87 1.0082 0.9539 ‐0.0543 ‐5.4%$ (37,793) 420068 Trmc Of Orangeburg & Calhoun 251 121 2741 1.6062 1.5207 ‐0.0855 ‐5.3%$ (1,874,844) 280133 Nebraska Spine Hospital,
    [Show full text]
  • Posting Date: June 1, 2021 This Posting
    Posting Date: June 1, 2021 This posting serves as notification of SFY 2021-22 Outpatient Hospital EAPG Base Rates for all Hospitals participating in Health First Colorado. Consistent with the SFY20-21 EAPG Base Rates, individual letters will not be issued to each hospital. This method of communicating hospital rates has been approved by Hospitals participating in our Hospital Engagement Meetings that occur every other month. Information about past and upcoming Hospital Engagement Meetings is available at https://www.colorado.gov/pacific/hcpf/hospital-engagement-meetings. Hospital Base Rate Increase SFY 2021-22: The outpatient hospital EAPG base rates reflect the 2.5% provider rate increase effective July 1, 2021, as mentioned in SB 21-205. The rates in this letter show a 2.5% increase of the EAPG base rates that were effective July 1, 2020. Request for Informal Reconsideration or Appeal: Reimbursement rates for outpatient hospital services were calculated according to the regulations of the Health First Colorado Program. If you disagree with these figures, you may file a written request for informal reconsideration with the Department within thirty (30) days from the “posting date” listed in this communication. The request shall state the specific component of the rate the Provider wants reconsidered and the Provider’s position. Requests that do not comply with the requirements of this section shall be considered incomplete and shall be denied. If you desire an informal reconsideration for your hospital’s July 1, 2021 Outpatient Base Rate, please send your written request including your position as to each identified concern regarding the rate determination to: Andrew Abalos Fee-for-Service Rates Section Department of Health Care Policy and Financing 1570 Grant Street Denver, CO 80203 You may file an appeal of the decision on the informal reconsiderations with the office of administrative courts, as set forth at 10 C.C.R.
    [Show full text]
  • Data Available in the Network
    Data Available in the CORHIO Network MSH:4 values are the identification codes associated with data senders on CORHIO Notifications reports. Admission/ Laboratory Pathology Radiology Radiology Transcription Patient Care Summary HIE provider Discharge/ Reports Images Notes Centered Data Documents Available in Transfer Home Alerts PatientCare 360 1st Care Medical Clinic √ HEALTH CURRENT (MSH:4 VALUE: FCMC_HEALTHCURRENT) A New Leaf √ HEALTH CURRENT (MSH:4 VALUE: ANEWLF_HEALTHCURRENT) A. T. Still University √ HEALTH CURRENT (MSH:4 VALUE: ATSU_HEALTHCURRENT) AACH Emergency Department √ RELIANCE (MSH:4 VALUE: AACH_RELIANCE) EHEALTH COLLABORATIVE Abbeville General Hospital √ LOUISIANA HEALTH INFORMATION EXCHANGE (MSH:4 VALUE:AGH_LAHIE) Abrom Kaplan Memorial Hospital √ LOUISIANA HEALTH INFORMATION EXCHANGE (MSH:4 VALUE: AKMH_LAHIE) Acadia General Hospital √ LOUISIANA HEALTH INFORMATION EXCHANGE (MSH:4 VALUE:ACADIAGH_LAHIE) Acadian Medical Center √ LOUISIANA HEALTH INFORMATION EXCHANGE (MSH:4 VALUE:AMC_LAHIE) Acadia‐St. Landry Hospital √ LOUISIANA HEALTH INFORMATION EXCHANGE (MSH:4 VALUE: ALH_LAHIE) Accu Care Urgent Care √ HEALTH CURRENT (MSH:4 VALUE: ACUC_HEALTHCURRENT) Adelante √ HEALTH CURRENT (MSH:4 VALUE: ADL_HEALTHCURRENT) Advanced Clinical Associates √ HEALTH CURRENT (MSH:4 VALUE: ADCA_HEALTHCURRENT) Advanced Healthcare Associates √ IDAHO HEALTH DATA EXCHANGE (MSH:4 VALUE: AHA_IHIE) ADVANCED PRACTICE MEDICAL CLINIC LLC √ UTAH HEALTH INFORMATION NETWORK (MSH:4 VALUE: ADPRME_UHIN) ADVANCED PULMONARY SLEEP DISORDER AND √ UTAH HEALTH INFORMATION
    [Show full text]
  • Official 30-Day Inpatient Hospital Rate Review – Posting Date
    Official 30-day Inpatient Hospital Rate Review – Posting Date: July 30, 2020 This posting serves as an updated notification of Fiscal Year (FY) 2020-21 Inpatient Hospital Base Rates for all Hospitals participating in Health First Colorado. One hospital provided evidence of incorrect data which resulted in a need to be updated. Since inpatient base rates must remain budget neutral, this changed the “% of Medicare Base Rate” for all hospitals and rural/urban peer group averages. Hospitals can update the calculation they received earlier by updating; 1) the peer group average if they are a new, low-discharge or critical access hospital, or 2) the “% of Medicare Base Rate” to 84.26% if they are a Prospective Payment System (PPS) hospital. This should result in same hospital base rate as listed in the new posting. Hospitals can also request the updated calculation used to arrive at their hospital’s Medicaid base rate by sending an email to Diana Lambe at [email protected]. Please remember to include hospital name and MEDICARE ID along with the request. Once CMS approval is received, all hospital claims with last service dates from 7/1/2020 will be adjusted to reflect the new Inpatient Hospital Base Rate. Hospital Base Rate Decrease FY2020-21: The inpatient hospital DRG base rates reflect the 1% provider rate decrease effective July 1, 2020, as detailed in Senate Bill HB20-1360. Request for Informal Reconsideration or Appeal: Reimbursement rates for inpatient hospital services were calculated according to the regulations of the Colorado Medicaid Program. If you disagree with these figures, you may file a written request for informal reconsideration with the Department within thirty (30) days from the “posting date” listed in this communication.
    [Show full text]
  • Patient-Concierge-Service-Brochure
    PATIENT CONCIERGE SERVICE The Steadman Clinic delivers the highest standard of orthopaedic care and personal attention to each patient. Included in our patient-focused culture, we offer complimentary Patient Concierge Services to assist with travel, entertainment, dining, activities and other special requests. Please contact our Patient Concierge at 970-479-5898 or [email protected], 8 am to 5 pm Monday thru Friday, to address non-medical inquiries. Please contact The Steadman Clinic number below for medical attention. PHYSICAL ADDRESS Te Steadman Clinic in Edwards, Colorado is 130 miles west of Te Steadman Clinic in Vail, Colorado is 120 miles west of Denver (DEN) and just 20 miles east of the Vail/Eagle County Denver (DEN) and just 30 miles east of the Vail/Eagle County Airport (EGE). Airport (EGE). The Steadman Clinic Edwards Please use the main entrance of Vail Health Hospital through 322 Beard Creek Road the 2018-2019 construction to access Te Steadman Clinic Edwards, CO 81632 Vail. Tis address may be used for driving directions and ofers complimentary valet service. Valet is available at Vail Health from 970-476-1100 8 am to 5 pm Monday thru Friday. The Steadman Clinic Vail Te Steadman Clinic in Frisco, Colorado is 95 miles west of 181 West Meadow Drive, Suite 400 Denver (DEN) and just 55 miles east of the Vail/Eagle County Airport (EGE). Vail, CO 81657 The Steadman Clinic Frisco 970-476-1100 360 Peak One Drive, Suite 340 Frisco, CO 80443 970-476-1100 PATIENT CONCIERGE SERVICE 2 AIR TRANSPORTATION GROUND TRANSPORTATION AIRPORTS DENVER INTERNATIONAL AIRPORT (DEN) SILENT PARTNER LIMOUSINES 8500 Peña Blvd Denver, CO 80249 Private Limousines | $$$ 303-342-2000 970-470-2587 Denver International Airport is located 120 miles, approximately https://www.silentpartnerlimousines.com a 2 hour drive, east of Vail and is a non-stop destination for major Silent Partner Limousines is a HIPAA certifed transportation domestic and international airlines.
    [Show full text]
  • Curriculum Vitae
    August 2018 CURRICULUM VITAE NAME: Ernest E. Braxton Jr, MD, MBA, FAANS 37347 US Highway 6, #201 Avon, CO 81620 Work: (970) 393-2366 Mobile: (210)-488-8974 E-mail: [email protected] PERSONAL INFORMATION Date of Birth: April 9, 1975 Place of Birth: Altus, OK Citizenship: United States EDUCATION 06/1993-05/1997 BS United States Air Force Academy, Colorado Springs, Colorado 08/1997-05/2001 MD University of Pennsylvania, Philadelphia, Pennsylvania 07/2001-06/2002 Internship, Wilford Hall Medical Center, Lackland AFB, Texas 07/2003-06/2009 Residency in Neurosurgery, Allegheny General Hospital, Pittsburgh, Pennsylvania 08/2005-05/2007 MBA, Carnegie Mellon University, Pittsburgh, Pennsylvania 07/2008-06/2009 Chief Resident in Neurosurgery, Allegheny General Hospital, Pittsburgh, Pennsylvania CURRENT PROFESSIONAL POSITIONS 07/2017 Private Practice Vail Summit Orthopedics and Neurosurgery 108 South Frontage Road West, Suite 206 Vail, Colorado 81657 BOARD CERTIFICATION 04/2016 Passed, American Board of Neurologic Surgery Boards (ABNS) MEDICAL LICENSURE 2002- Indiana License #0105667A 2010 Maine License #018397 2011 Texas License #N8618 2017 Colorado License #0058687 HONORS/AWARDS 1993 National Defense Service Medal with 1 Service Star 1997 AF Training Ribbon August 2018 1997 AF Outstanding Unit Award with 3 Oak Leaf Clusters 2001 Global War on Terrorism Service Medal 2003 United States Air Force Commendation Medal 2003 Korean Defense Service Medal 2003 Nuclear Deterrence Operations Service Medal 2006 Canfield-Roseman Entrepreneur of the year award 2011 Afghanistan Campaign Medal with 2 Service Stars 2011 Air Force Expeditionary Service Ribbon with Gold Border 2011 NATO Medal 2015 AF Organizational Excellence Award 2017 AF Longevity Service with 3 Oak Leaf Clusters PREVIOUS PROFESSIONAL MILITARY POSITIONS 07/2002-06/2003 General Medical Officer, 51st Medical Group, Osan AB, Korea 08/2009-07/2014 Staff Neurosurgeon, Wilford Hall Medical Center, Lackland AFB, Texas 10/2009-06/2015 Staff Neurosurgeon, Brooke Army Medical Center, Ft.
    [Show full text]
  • Maximum Reimbursement Rate Formula * Base CAH Type 20% Independent 20% Payer
    Maximum Reimbursement Rate Formula * Base 155% CAH 20% Independent Type 20% Payer Mix (share of Medicare and Medicaid patients) Payer Mix up to 30% Managing cost of care (Expenses, Price, and Margin) Efficiency up to 40% * For a detailed description of the factors included in the hospital reimbursement formula, please see page 12 of the February 21, 2020, actuarial report prepared by Wakely Consulting Group, LLC, available at: https://www.colorado. gov/pacific/sites/default/files/Wakely%20Colorado%20Public%20Option%20Report.pdf Maximum Hospital Type Reimbursement Rate Animas Surgical Hospital Independent 175% Arkansas Valley Regional Medical Center Independent, Critical Access 236% Aspen Valley Hospital Independent, Critical Access 195% Avista Adventist Hospital System 181% Banner Fort Collins Medical Center System 177% Boulder Community Health Independent 193% Castle Rock Adventist Hospital System 178% Children's Hospital Colorado Independent 179% Colorado Canyons Hospital and Medical Center Independent, Critical Access 208% Colorado Plains Medical Center System 168% Community Hospital Independent 207% Delta County Memorial Hospital Independent 214% Denver Health Medical Center Independent 208% East Morgan County Hospital System, Critical Access 210% Estes Park Health Independent, Critical Access 205% Good Samaritan Medical Center System 163% Grand River Hospital District Independent, Critical Access 205% Gunnison Valley Health Independent, Critical Access 198% Haxtun Hospital District Independent, Critical Access 195% Heart of the Rockies
    [Show full text]
  • Public Health Agencies Will Be Administered to Health Care Workers at Local Hospitals That Do Not Have the Capability to Store Vaccine
    Release 12/11: Colorado prepares to distribute first shipments of COVID-19 vaccine to health care facilities throughout state Colorado State Joint Information Center <[email protected]> Fri 12/11/2020 9:35 AM To: SOC_JICMediaList <[email protected]> INFORMACIÓN SEGUIDA EN ESPAÑOL AL ESTAR DISPONIBLE FOR IMMEDIATE RELEASE CONTACT: COVID-19 MEDIA LINE: 303-900-2849 (Please leave a message) Email: [email protected] Colorado prepares to distribute first shipments of COVID-19 vaccine to health care facilies throughout state Remote, Colo. (Dec. 11, 2020): In ancipaon of the first shipments of Pfizer and Moderna COVID-19 vaccines in December, the Colorado Department of Public Health and Environment (CDPHE) has collaborated closely with local public health agencies across the state to prepare health care facilies to receive the vaccine. These health care facilies will then distribute the vaccine to frontline health care workers. CDPHE has idenfied locaons across the state with ultra-low temperature freezers to receive the first shipment of the Pfizer vaccine. These locaons were chosen for their unique abilies to store, monitor, and handle vaccines in ultra-cold temperatures (-60°C to -80°C), as well as their willingness to redistribute COVID-19 vaccine(s) to other providers in their regions. The state also considered equitable geographic distribuon as well as transportaon logiscs given expected winter condions in the coming months. To be as equitable as possible, the state also purchased 10 ultra-cold storage units. CDPHE has distributed 8 of these and the remaining two will be distributed today. The federal government will deliver a shipment of the Moderna vaccine shortly aer the first shipment of the Pfizer vaccine.
    [Show full text]
  • Physician Compensation and Productivity Survey Report
    2019 Physician Compensation and Productivity Survey Report Survey data effective January 1, 2019 © 2019 SullivanCotter, Inc. All rights reserved. 200 W. Madison Street, Suite 2450 Chicago, IL 60606-3416 2019 PHYSICIAN COMPENSATION AND PRODUCTIVITY SURVEY REPORT Survey data effective January 1, 2019 LICENSE AGREEMENT LICENSE AGREEMENT By accessing or downloading the Survey Report files online or by opening the packaging for this Survey Report, you agree to the terms of this License Agreement (this “Agreement”). If you do not agree to these terms and have not yet accessed or downloaded the Survey Report files or opened the packaging for this Survey Report, you may cancel your online purchase or download at this time or you may return this Survey Report to SullivanCotter, Inc. for a full refund within thirty (30) days of receipt, but you may not access or download the Survey Report files or open the packaging for, or otherwise use, this Survey Report. Accessing or downloading the Survey Report files or opening the packaging, or otherwise using, this Survey Report binds you to this Agreement. This Agreement is entered into by and between SullivanCotter, Inc. ("SullivanCotter") and the purchaser or participant of this Survey Report (the “Licensee”). In consideration of the mutual covenants in this Agreement, SullivanCotter and the Licensee agree as follows: Grant of License. This Survey Report contains the aggregation of compensation data and other data provided to SullivanCotter by its survey participants, statistics, tables, reports, research, aggregations, calculations, data analysis, formulas, summaries, content, text and other information and materials provided to the Licensee by SullivanCotter through any other means, whether digital or hard copy, related thereto (the “Aggregated Data”).
    [Show full text]
  • COVID-19 LIST of VACCINE RECIPIENTS 010821 1 Banner Fort Collins Medical Center
    COVID-19 List of vaccine recipients To be as fair and efficient with distribution as possible, Colorado has developed a phased approach to vaccine distribution to save lives and end the crisis that has been brought on by the pandemic as quickly as possible. The Colorado Department of Public Health and Environment (CDPHE) has collaborated closely with local public health agencies across the state to prepare health care facilities to receive the vaccine. These health care facilities will then administer the vaccine to people who want one and are eligible under the phased distribution plan. Colorado is requesting enough vaccines to provide for all Coloradans. Because of supply chain limitations, we expect we will receive regular COVID-19 vaccine allocations from the federal government on a weekly basis. The federal government is determining the allocation amount by the size of every state’s total population and the quantity of ready-to-ship doses from the manufacturers. The following locations have received vaccine shipments: Alamosa County Public Health Department Animas Surgical Hospital Ardas Family Medicine Arkansas Valley Regional Medical Center Aspen Valley Hospital Avista Adventist Hospital Baca County Public Health Agency Banner Columbine Family Practice Loveland Banner East Morgan County Hospital COVID-19 LIST OF VACCINE RECIPIENTS 010821 1 Banner Fort Collins Medical Center Banner Health Clinic Summit View Banner Health Family Care Clinic in Sterling Banner McKee Medical Center Bent County Public Health Bloom Healthcare Physician
    [Show full text]