8children, it was not upheld for the REM population.20 The Center provided the Department withCDs to be distributed to the MCOs with information on current HealthChoice enrollees that hadno dental services between April 2004 and April 2007.21Encounter Data Reporting and Validation: Through monthly, quarterly, and annual reports tothe Department and MCOs, the Center verified the completeness, correctness, and reliability ofencounter data. Encounter data is used not only to assess access to care and network adequacy,but also to develop payment rates for HealthChoice. Monthly reports consist of date of serviceanalyses and MCO data submission projections. Quarterly reports show services available bycounty. Annual reports focus on the ratio of service users to enrollees; the distribution ofdiagnoses; diagnoses per claim; and cohorts by risk-adjusted category assignments. The processthe Center follows for continuously monitoring and validating encounter data is described in aNovember 2005 report.22 Maryland is recognized nationally for the completeness and quality ofits encounter data. As part of the validation process in FY 2007, the Center established thesample size needed in order to insure statistical accuracy.23Provider Reporting: The Center also prepared a series of reports on HealthChoice providers.Quarterly reports provide data on the number of providers and primary care providers by regionand by MCO; enrollment for primary care providers by region and by MCO; and specialists byregion and by MCO specialty network.Work Groups: In FY 2007, Center staff participated with Department staff in monthly MCOInternal Work Group meetings, monthly MCO Liaison meetings, and semi-annual MCOEncounter Data Work Group meetings.Estimation of Regional Medicaid Capacity: The Center estimated the local and regionalMedicaid capacity as of June 2006. The population was limited to HealthChoice providers andanalyzed patient/provider ratios as well as payments and services for FY 2005.24Montgomery County Cost Allocation Plan: At the request of the Department, the Centerreviewed the methodology for the Montgomery County cost allocation plan. The review assistedthe county in clarifying the methodology, thereby increasing its ability to reach the desiredoutcomes.2520 REM, Foster Care, and HealthChoice Dental Analysis, June 28, 2007. Memo from David Idala to Tricia Roddy,transmitted by e-mail.21 Dental Data, June 1, 2007. Cover Memo and CDs to Tricia Roddy from Ann Volpel.22 Encounter Data Validation Report CY 2004, November 2005.23 Sample Size Needed for Encounter Data, Report transmitted by e-mail from Susan Tucker to Tricia Roddy onJanuary 31, 2007.24 Local and Regional Estimation of Medicaid Capacity as of June 2006, Report transmitted by memo from ToddEberly to Rosemary Murphey on October 11, 2006.25 Montgomery Cost Allocation Plan, May 24, 2007. Memo from Farhad Khalatbari to Hank Fitzer transmitted bye-mail from Ann Volpel to Hank Fitzer on May 25, 2007.
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