Developed by the Maine Public Health Association Tobacco Policy Committee [ako]
Data Provided by Office of MaineCare Servi...
Developed by the Maine Public Health Association Tobacco Policy Committee [ako]
Data Provided by Office of MaineCare Servi...
Developed by the Maine Public Health Association Tobacco Policy Committee [ako]
Data Provided by Office of MaineCare Servi...
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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

  1. 1. Developed by the Maine Public Health Association Tobacco Policy Committee [ako] Data Provided by Office of MaineCare Services, November 2010 MaineCare Tobacco Treatment Benefit Claims Data Review—State FY 2010 Pharmacotherapy: Claim Count Member Count Total Quantity Total Days Supplied Total Paid by MaineCare Program 28,618 13,533 1,508,598 575,894 $1,267,976.10 Paid Claims for Tobacco Cessation Medicaitons SFY 2010 $17,509.85 $363,368.14 $121,331.01 $15,515.42 $21,255.56 $303,575.20 $968.14 0 50,000 100,000 150,000 200,000 250,000 300,000 350,000 400,000 Buproban Chantix Gum Lozenge Inhaler Patch Spray Medication Type TotalAmount Claims Cost
  2. 2. 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): Claim Count Member Count Total Billed Units Total Paid Units Total Paid by the MaineCare Program Total Adjusted Amount 2,614 2,066 2,718 2,488 $33,234.14 $35,894.18 Paid Claims fr Tobacco Cessation Counseling $250.05 $24,703.83 $60.00 $7,730.66 $3,149.64 0 5,000 10,000 15,000 20,000 25,000 30,000 99401 99402 99403 99406 99407 Procedure Code TotalAmount Claim Count Total Cost to MaineCare Procedure Code Medicaid Rate Procedure Description 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
  3. 3. 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 $1,056.30 $40,562.26 $11,038.61 $705.63 $36,528.11 $1,816.81 $248.20 $- $5,000.00 $10,000.00 $15,000.00 $20,000.00 $25,000.00 $30,000.00 $35,000.00 $40,000.00 $45,000.00 Buproban Chantix Gum Lozenge Patch Inhaler Spray Medication TotalCopayPaid 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).

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