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Maine care tobacco treatment benefit claims data fy 2010

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Maine care tobacco treatment benefit claims data fy 2010 Maine care tobacco treatment benefit claims data fy 2010 Document Transcript

  • MaineCare Tobacco Treatment Benefit Claims Data Review—State FY 2010 Pharmacotherapy: Total Total Paid by Member Total Days MaineCare Claim Count Count Quantity Supplied Program 28,618 13,533 1,508,598 575,894 $1,267,976.10 Paid Claims for Tobacco Cessation Medicaitons SFY 2010 400,000 $363,368.14 350,000 $303,575.20 300,000 250,000 Total Amount Claims 200,000 Cost 150,000 $121,331.01 100,000 50,000 $17,509.85 $21,255.56 $15,515.42 $968.14 0 Buproban Chantix Gum Lozenge Inhaler Patch Spray Medication Type Developed by the Maine Public Health Association Tobacco Policy Committee [ako] Data Provided by Office of MaineCare Services, November 2010
  • Counseling (99401, 99402, 99403, 99406, 99407): Total Total Paid by Total Claim Member Billed Total Paid the MaineCare Adjusted Count Count Units Units Program Amount 2,614 2,066 2,718 2,488 $33,234.14 $35,894.18 Paid Claims fr Tobacco Cessation Counseling 30,000 $24,703.83 25,000 20,000 Total Amount 15,000 10,000 $7,730.66 5,000 $3,149.64 $250.05 Claim Count $60.00 0 99401 99402 99403 99406 99407 Total Cost to Procedure Code MaineCare Procedure Medicaid Procedure Description Code Rate 99401 $5.00 Preventive counseling, individual, 15 min 99402 $22.00 Preventive counseling, individual, 30 min 99403 $10.00 Preventive counseling, individual, 45 min 99406 $8.67 Intensive Counseling (Behavioral Change) 3-10 MIN 99407 $16.81 Intensive Counseling (Behavioral Change) < 10 MIN Developed by the Maine Public Health Association Tobacco Policy Committee [ako] Data Provided by Office of MaineCare Services, November 2010
  • Copay Costs to Medicaid Recipients By Pharmacotherapy SFY 2010 $45,000.00 $40,562.26 $40,000.00 $36,528.11 $35,000.00 $30,000.00 Total Copay Paid $25,000.00 $20,000.00 $15,000.00 $11,038.61 $10,000.00 $5,000.00 $1,816.81 $1,056.30 $705.63 $248.20 $- Buproban Chantix Gum Lozenge Patch Inhaler Spray Medication Elimination of copay requirements, based on SFY 2010 data, would cost the State of Maine less than $100,000 annually ($91,956 in SFY 2010). Developed by the Maine Public Health Association Tobacco Policy Committee [ako] Data Provided by Office of MaineCare Services, November 2010