Before passage of MMA, the OIG had very little interest in PAPs that provided free drugs directly to uninsured patients because there were no FHCP dollars involved.
02-1, we approved an arrangement for drug manufacturers to pool contributions in an independent foundation that awards grants based on need, without reference to any specific contributing drug manufacturer"); and (2) manufacturer PAPs in which companies provide free drugs to financially needy beneficiaries, as long as no FHCP is billed for the drugs.
According to FHCP, participating physicians were told by the plan to expect that FHK enrollees would be like Medicaid patients in their utilization of care.
The FHCP submitted a comprehensive benefit package priced at $58.
This disproportionate share of ER utilization early in enrollment might imply that pent-up demand exists, but is being served in ERs, rather than in the offices of FHCP physicians.
As part of the risk of covering this population, FHKC and FHCP expected utilization to occur in particularly inefficient ways.
These data suggest the possibility that FHK participants were substituting visits to their primary care physician or the FHCP walk-in clinic for more costly ER care, much as FHCP sought.
FHCP attributes the decline in ER use and the increase in use of primary care physicians to three features of the program.
A second way in which FHCP sought to reduce ER utilization was by educating ER physicians.
After a rigorous review of Electronic Health Record vendors, FHCP selected Allscripts for its ease of use, its off-the-shelf non-proprietary technology, and its interoperability with other information technology systems, said Roy Klostermeyer, FHCP's Chief Information Officer.
FHCP will interface the Electronic Health Record with many existing FHCP systems such as practice management, laboratory, transcription and radiology, as well as clinical instrumentation including blood pressure, pulse, temperature and pulse oximetry.
FHCP has 10 facilities serving more than 62,000 members consisting of employer groups, Medicare beneficiaries, and Healthy Kids in Volusia and Flagler Counties of east central Florida.