Docstoc

tracking

Document Sample
tracking Powered By Docstoc
					Source Document   PPACA Sec. # Description                                                   Effective Date      SFY '10 $ Impact            SFY '11 $ Impact         Notes
                                                                                                                gross         g.f.         gross           g.f.
                    2001 &       Loss of Catamount premium revenues due to MOE                                                                                       not applicable during 2011-2013 with respect to non-pregnant disabled adults > 133% FPL IF
NCSL 3/26/10       2001(b)(4)   requirements                                                 upon passage       (60,000)      (60,000)     (505,000)      (505,000) STATE CERTIFIES A DEFICIT AS OF 12/31/10
                                                                                                                                                                     Initial $795K savings (gross) forced current enrollees into HIPP if cost effective. Now assuming a
                                 HIPPS savings MIGHT not attainable due to MOE                                                                                      $200K savings by voluntary offering HIPP to current enrollees and follow HIPP (forced if cost
                                requirements                                                                          -              -     (595,000)      (212,237) effective) for new enrollees.
                                                                                                                                                                     brand name=15.1%-23.1% & generics=11%-13%. Est. based on 18% of ttl rebates due to (a)
                                 Increase rebate percentages and share back 100% of                                                                                 loss of OBRAs now collected btwn old and new; and (b) loss of supps due to guaranteed net unit
NCSL 3/26/10         2501       increase with feds                                              1/1/10        (6,150,000)   (2,327,160) (12,600,000)    (4,246,200) pricing. OPERATIONALLY VERY CUMBERSOME
                                 Unmarried children can remain on parents' insurance until
NCSL 3/26/10                    age 26                                                          9/1/10                -              -     (645,494)      (645,494) 1/2 year impact on state employee health insurance costs ($1,433,390 for SFY '12)
                                 Change in State-Only pharmacy costs due to 50%                                                                                      How to implement 50% reduction for donut hole only when it is a pharmaceutical company rate
                     3301       reduction of brand name drugs                                   1/1/11                -              -      750,000        750,000 reduction?
                                                                                                                                                                     MedMetrics estimate. One-time benefit. Effective 1/1/10 but savings won't hit 'til 3/11 (IF we can
                     3315       Provide $250 payment to seniors who hit donut hole              1/1/11                -              -      590,000        590,000 collect instead of beneficiary)
                                                                                                                                                                     FUL going from 250% AWP to 175% but not increasing MAC. No one has access to AMP so
                                                                                                                                                                    calculate the savings. Q4 2009 is 2.7% of all claims priced of FUL. Ttl drug spend @ FUL for
PPACA                2503       Provide adequate pharmacy reimbursement                         1/1/11                -             -      (300,000)      (101,100) 2009 +/- $3.3M. If savings as high as 20% then = $600K
                                                                                                              (6,210,000)   (2,387,160) (13,305,494)    (4,370,031)
VHAP           2005     2006     2007     2008     2009     2010      2011     2012
Enrollment      22,081   22,525   22,047   25,047   29,045   33,624    38,426   38,718
p.m.p.m.     $ 277.13 $ 286.06 $ 282.76 $ 300.98 $ 324.95 $  310.53 $ 331.00 $ 338.02


FMAP            60.42%   58.90%   58.82%   59.01%    59.35%   58.91%    58.72%   58.72%
Enhanced         0.00%    0.00%    0.00%    0.00%     6.75%   11.05%     5.61%    0.00%
State           39.58%   41.10%   41.18%   40.99%    33.90%   30.04%    35.67%   41.28%


Enhanced $
  2013     2014      2015      2016      2017      2018      2019
   41,512   44,306    47,100    49,894    52,688    55,482    58,276
$ 347.05 $  356.08 $  365.10 $  374.13 $  383.16 $  392.18 $  401.21


   58.72%      58.72%       58.72%       58.72%       58.72%       58.72%       58.72%
    0.00%      21.74%       25.86%       28.89%       29.02%       31.75%       34.28%
   41.28%      19.54%       15.42%       12.39%       12.26%        9.53%        7.00%


            41,157,256   53,363,699   64,714,115   70,301,738   82,902,090   96,179,556   408,618,455

				
DOCUMENT INFO