Appendix__K_-_MCOs_to_be_Reviewed.xlsx
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- HHSM-500-2015-RFP-0113
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Appendix K - MCOs to be Reviewed
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MCOs to be reviewed
| MCOs to be Reviewed | |||||||
| Base Year | |||||||
| Contract Number | Plan Name | Years to Review | Number of Years | Number of Claims to Review | Location | Primary Payment Mechanism** | Primary statistical method*** |
| 90091* | United Mine Workers of America Health & Retirement | 2012-2013 | 2 | 700 | Washington, DC | Fee-for-service | Paid Claims |
| H1251 | Hawaii Medical Service Association (HMSA) | 2011-2013 | 3 | 1050 | Honolulu, HI | Fee-for-service | Eligible |
| H2150 | Kaiser Foundation Health Plan of the Mid-Atlantic States | 2012-2014 | 3 | 1050 | Rockville, MD | Salaried Physicians | RVU |
| H2461 | Blue Cross Blue Shield of Minnesota | 2013-2014 | 2 | 700 | Eagan, MN | Fee-for-service | Billed Charges |
| H6360 | Healthspan Integrated Care | 2012-2014 | 3 | 1050 | Cleveland, OH | Salaried Physicians | RVU |
| * Indicates HCPP - 1833 Cost Plan. Otherwise, default is HMO/CMP - 1876 Cost Plan. |
| ** Primary payment mechanism is as indicated on the most recently reviewed cost report. Plan may also utilize additional payment mechanisms or a variation of the one listed here. |
| *** Primary statistical method is as indicated on the most recently reviewed cost report. Plan may also utilize additional statistical methodologies or a variation of the one listed here. |
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