HomeMy WebLinkAboutAgenda - 08-19-2003-8nORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: August 19, 2003
Action Agenda
Item No. ~- n
SUBJECT: Medicaid Fee Adjustments
DEPARTMENT: Health PUBLIC HEARING: (Y/N) No
ATTACHMENT(S): INFORMATION CONTACT:
Rosemary Summers, ext 2411
TELEPHONE NUMBERS:
Hillsborough 732-8181
Chapel Hill 968-4501
Durham 688-7331
Mebane 336-227-2031
PURPOSE: To approve adjustments in Medicaid fees for certain health department
procedures.
BACKGROUND: Twice a year, the state Medicaid office reviews the fees that are eligible for
reimbursement. The Orange County Health Department received notice in July from the North
Carolina Division of Public Health that fees were changed as of April 1, 2003. The following
fees are affected by these rate changes in the Health Department:
Service Current Fee** Proposed
Fee*
Insert IUD N/A $80
Pure Tone Audiomet ,Air $15 $20
Health & Behavior
Intervention N/A $23
Mirena IUD N/A $420
Tooth Extraction, each
additional $56 $60
*Proposed fee for 100% pay clients
**N/A=New Fee
The Health Department already provides all of the services noted above. The Mirena IUD is a
new technology and there previously was no charge allowed for the others. It should be noted
that the Health Department also has a sliding fee scale that is applied to all charges for clients
with incomes less than 200% of the federal poverty level. Participation by clients under this
sliding fee scale varies due to economic and other factors, but generally more than 80% of the
clients served benefit from this sliding scale fee structure or Medicaid reimbursement.
The Board of Health reviewed these fees at its July meeting and is recommending that the
Board of Commissioners approve these fee changes.
FINANCIAL IMPACT: Without these fee adjustments, the Health Department would either not
be able to bill Medicaid for these services or would be required to bill Medicaid at a cost below
the actual cost of providing the service. While the Department has not previously provided
three of the services above, patients have inquired about their availability.
RECOMMENDATION(S): The Manager recommends that the Board approve the fee
adjustments listed above.