Corrective Action Plan: The Agency has submitted the Medical Loss Ratio report for the year ending 12/31/2021 no later than 12/31/2022. The report was delivered on 12/29/2022. Department of Vermont Health Access (DVHA) and the Agency of Human Services (AHS) have worked together over the past year t...
Corrective Action Plan: The Agency has submitted the Medical Loss Ratio report for the year ending 12/31/2021 no later than 12/31/2022. The report was delivered on 12/29/2022. Department of Vermont Health Access (DVHA) and the Agency of Human Services (AHS) have worked together over the past year to define the roles and responsibilities needed to deliver the Medical Loss Ratio (MLR) to AHS by the due date. AHS has agreed to provide Medicaid summaries, and once December enrollment is available, provide capitation rates multiplied by final enrollment for total calendar year expenditures. Additional to AHS deliverables, DVHA has updated its Standard Operating Procedures (SOP) to reflect the deliverables from AHS, additional detail to support each step in the process, and validation steps for AHS upon completion of the report by DVHA. The steps that have been added to the process allow for a more comprehensive review of the deliverable by both departments which will allow for an on-time delivery in its entirety by the due date of December 31. Scheduled Completion Date of Corrective Action Plan: December 29, 2022 Contacts for Corrective Action Plan: Patrick Rooney, DVHA Financial Director patrick.rooney@vermont.gov Allison Nowak, DVHA Financial Director allison.jensen@vermont.gov Tracy O?Connell, AHS-CO Financial Director tracy.oconnell@vermont.gov Peter Moino, AHS Director of Internal Audit peter.moino@vermont.gov