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MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH August 23, 2017 S:\Managers Working Files\BOH\Agenda & Abstracts\2017 Agenda & Abstracts/ August Page 3 • Total Billing Accuracy: Continuing with the goal of 90% billing accuracy set in FY 14-15, the average billing accuracy rate for medical at the end of FY 16-17 is 90% as compared to 95% in FY 15-16 and the average rate for dental for FY 16-17 is 98% as compared to 97% in FY 15-16. • Dental Earned Revenue by Source: The FY 16-17 average monthly revenue ($41k/month) ended the fiscal year below our budget projection ($47.5k/month) due to decreased Medicaid and Commercial Insurance patients (Self-pay receipts exceeded budget) and level with our FY 15-16 average of $40k/month. FY 16-17 dental revenue totaled $497k at the end of the fourth quarter. • Medical Earned Revenue by Source: Medical earned revenue is currently below the budgeted projection for FY 16-17. The monthly average after the fourth quarter ($55k/month) exceeded FY16 ($50k/month) but lower than our budget projection ($59.6k/month). Medical revenue totaled $663k for FY 16-17. The BOH had questions that were addressed by Ms. Crawford. D. 2013 Medicaid Cost Settlement Program Reimbursement Rebecca Crawford, Financial and Administrative Services Director, updated the Board of the ongoing 2103 Medicaid Cost Settlement. The Health Department received official notification of a Notice of Program Reimbursement on August 3rd from the NC DHHS Department of Medical Assistance (DMA). This notice referenced the 2013 Medicaid Cost Settlement report (period ending June 30, 2013.) As you may remember, the Medicaid cost settlement process has been contested since DMA required a new cost report methodology beginning in State Fiscal Year (SFY) 2011. The main point of contention is the calculation of the Medicaid population statistic. After a long debate, the primary issue of the Medicaid population statistic has been clarified by a recent ruling in a lawsuit between DMA and Cabarrus County. DMA prevailed and will retroactively settle all Local Health Department (LHD) cost settlements beginning with SFY 2013. SFY 2013 will be the only year where an overpayment (by DMA) is applied since DMA started using the new statistic prior to payments made in SFY 2014. Orange County is in a payback situation and owes a total of $200,524 to DMA. We received funds in 2015 from the state legislature to offset the loss incurred by the SFY 2013 overpayment in the amount of $219,043.90, which when combined with the payback amount referenced above, leaves us with a net gain of $18,519.90. DMA has offered LHD’s the option to either accept the payback amount and remit payment or appeal the proposed payback by “scrubbing” our data according to the agreed upon process listed in the Cabarrus County court ruling. We’ve learned this made a significant reduction in the payback amount for Cabarrus County. Our staff have determined it is in our best interest to work with the NC Public Health Association (who historically has prepared our annual cost settlement report) to “scrub” our 2013 data. Ms. Crawford also stated that, for FY 15/16, Orange County will receive $800,000. She also mentioned that DMA now requires patient names and birth dates to be included in the coding/billing process. The BOH had questions that were addressed by Ms. Crawford and Dr. Cilenti.