OKLAHOMA HEALTH CARE AUTHORITY SUMMARY OF REVENUES & EXPENDITURES: Fund 255: OHCA Medicaid Program Fund For the Fiscal Year Ended June 30, 2009
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1 Fund 255: OHCA Medicaid Program Fund FY 09 FY 09 Total State REVENUES Revenue Share Tobacco Tax Collections 54,001,198 54,001,198 TOTAL REVENUES $ 54,001,198 $ 54,001,198 EXPENDITURES FY 09 FY 09 Total Program Costs: Total $ YTD State $ YTD State $ Cost Adult Dental Services $ 7,683,028 $ 2,596,863 Remove Hospital Day Limit 10,554,280 3,567,347 Hospital Rate Increase - Statewide Median +2% 15,168,373 5,126,910 Increase Physician Visits from 2 to 4 per Month 419, ,794 Increase Physician Office Visits/OB Visits to 90% of Medicare 24,114,190 8,150,596 Increase Emergency Room Physician Rates to 90% of Medicare 11,416,825 3,858,887 Pay 50% of Medicare Crossover - Physician/Ambulance/OP 16,271,950 5,499,919 Nursing Facility 7% Rate Increase 33,334,436 11,267,039 Enhanced Drug Benefit for Adults ,206,404 7,167,765 Enhanced Drug Benefit for Waiver Adults ,113,827 6,122,474 TEFRA Services 11,653,095 3,938,746 SoonerRide 38,210 12,915 Replace NSGO UPL Revenues 15,799,308 5,340,166 Total Program Costs $ 185,773,435 $ 62,791,421 $ 62,791,421 TOTAL SHATE SHARE OF COSTS $ 62,791,421 Note: Expenditure amounts are for informational purposes only. Actual payments are made from Fund 340. Revenues deposited into the fund are tranferred to Fund 340 to support the costs, not to exceed the calculated state share amount. Page 7
2 Summary of Revenues & Expenditures: OHCA FY09 FY09 % Over/ REVENUES Budget YTD Actual YTD Variance (Under) State Appropriations $ 733,070,530 $ 733,070,530 $ - 0.0% Stimulus Funds Appropriated 30,000,000 30,000, % Federal Funds 2,012,170,892 1,989,579,247 (22,591,645) (1.1)% Tobacco Tax Collections 47,387,457 54,902,450 7,514, % Quality of Care Collections 51,173,812 51,553, , % FY 08 & FY 09 Carryover Committed to FY 10 - (11,420,486) (11,420,486) 0.0% Prior Year Carryover 33,438,657 33,438, % Drug Rebates 115,205, ,566,295 2,360, % Medical Refunds 22,060,109 33,052,207 10,992, % Other Revenues 19,875,604 20,431, , % Stimulus Funds 149,298, ,298, % - TOTAL REVENUES $ 3,213,680,958 $ 3,201,471,626 $ (12,209,332) (0.4)% FY09 FY09 % (Over)/ EXPENDITURES Budget YTD Actual YTD Variance Under ADMINISTRATION - OPERATING $ 38,078,366 $ 37,529,165 $ 549, % ADMINISTRATION - CONTRACTS $ 70,406,804 $ 59,827,280 $ 10,579, % MEDICAID PROGRAMS Managed Care: SoonerCare Choice 61,175,403 62,491,546 (1,316,143) (2.2)% Acute Fee for Service Payments: Hospital Services 879,745, ,331,328 (7,586,087) (0.9)% Behavioral Health 250,699, ,045, , % Physicians 366,073, ,899,242 (3,825,356) (1.0)% Dentists 140,057, ,732, , % Other Practitioners 42,802,791 41,657,618 1,145, % Home Health Care 18,221,707 18,022, , % Lab & Radiology 22,788,037 23,077,188 (289,151) (1.3)% Medical Supplies 55,944,551 54,894,858 1,049, % Ambulatory Clinics 58,440,408 58,182, , % Prescription Drugs 359,616, ,952,343 10,664, % Miscellaneous Medical Payments 27,977,424 27,989,622 (12,198) (0.0)% Other Payments: Nursing Facilities 520,283, ,453,118 1,830, % ICF-MR Private 56,129,815 55,661, , % Medicare Buy-In 113,352, ,946, , % Transportation 24,781,722 24,822,866 (41,144) (0.2)% Part D Phase-In Contribution 63,523,409 62,737, , % Total OHCA Medical Programs 3,061,614,088 3,056,898,334 4,715, % OHCA Non-Title XIX Medical Payments 89,382 40,128 49, % TOTAL OHCA $ 3,170,188,640 $ 3,154,294,906 $ 15,893, % REVENUES OVER/(UNDER) EXPENDITURES $ 43,492,318 $ 47,176,720 $ 3,684,402 Page 1
3 Total Medicaid Program Expenditures by Source of State Funds Health Care Quality of Medicaid BCC Other State Category of Service Total Authority Care Fund HEEIA Program Fund Revolving Fund Agencies SoonerCare Choice 67,875,621 62,371, , ,905 5,226,887 Inpatient Acute Care 701,309, ,700, ,687 5,680,683 43,581,189 5,634,425 31,225,580 Outpatient Acute Care 192,117, ,177,316 41,604 3,189,031-4,709,297 - Behavioral Health - Inpatient 139,141, ,273,745-3,705-2,991 7,860,819 Behavioral Health - Outpatient 8,378,960 8,378, Behavioral Health - Clinc 142,943, ,083,743-59, ,737 33,657,746 Behavioral Health - Case Management 1,163,574 1,159, ,907 Residential Behavioral Management 30,648, ,648,928 Targeted Case Management 73,160, ,160,376 Therapeutic Foster Care Physicians 394,855, ,784,924 58,101 5,997,502 50,192,044 14,864,173 26,958,606 Dentists 139,735, ,818,724-3,015 7,683, ,792 - Other Practitioners 41,790,201 40,366, , , ,369 64,004 - Home Health Care 18,024,497 17,935,998-1,725-86,774 - Lab & Radiology 23,695,585 22,236, , ,321 - Medical Supplies 55,205,699 51,673,073 2,897, , ,305 - Ambulatory Clinics 64,949,383 57,487, , ,816 6,325,163 Personal Care Services 10,862, ,862,975 Nursing Facilities 518,453, ,572, ,801,372-42,068,003 11,055 - Transportation 24,822,866 22,285,633 2,484,266-38,210 14,758 - GME/IME/DME 88,265, ,265,099 ICF/MR Private 55,661,063 36,744,291 18,056, , ICF/MR Public 68,886, ,886,706 CMS Payments 175,683, ,102,803 5,581, Prescription Drugs 354,345, ,100,998-5,393,230 39,320,231 3,531,113 - Miscellaneous Medical Payments 28,489,622 26,617, ,000 1,250, ,903 - Home and Community Based Waiver 154,020, ,020,847 Homeward Bound Waiver 93,117, ,117,952 Money Follows the Person 161, ,748 In-Home Support Waiver 24,864, ,864,587 ADvantage Waiver 207,594, ,594,375 Family Planning/Family Planning Waiver 5,338, ,338,242 Premium Assistance* 27,940, ,940, Total Medicaid Expenditures 3,933,504,809 2,626,874, ,853,527 50,429, ,773,435 31,397, ,176,633 * Includes $27,940, paid out of Fund 245 Page 2
4 Summary of Revenues & Expenditures: Other State Agencies FY09 REVENUE Actual YTD Revenues from Other State Agencies $ 274,961,188 Revenues from DHS for TFC Expenditures - Federal Funds 575,865,593 Stimulus Funds Through Invoice Billlings 13,944,275 TOTAL REVENUES $ 864,771,056 EXPENDITURES Actual YTD Department of Human Services Home and Community Based Waiver $ 154,020,847 Money Follows the Person 161,748 Homeward Bound Waiver 93,117,952 In-Home Support Waivers 24,864,587 ADvantage Waiver 207,594,375 ICF/MR Public 68,886,706 Personal Care 10,862,975 Residential Behavioral Management 24,148,408 Targeted Case Management 54,851,109 Total Department of Human Services 638,508,705 State Employees Physician Payment Capitation Payments 5,226,887 Physician Payments 26,958,606 Total State Employees Physician Payment 32,185,492 Education Payments Graduate Medical Education 39,000,000 Graduate Medical Education - PMTC 5,246,424 Indirect Medical Education 27,776,840 Direct Medical Education 16,241,835 Total Education Payments 88,265,099 Office of Juvenile Affairs Targeted Case Management 3,160,632 Residential Behavioral Management - Foster Care 130,497 Residential Behavioral Management 6,370,023 Total Office of Juvenile Affairs 9,661,152 Department of Mental Health Targeted Case Management 370,527 Hospital 7,860,819 Mental Health Clinics 33,657,746 Total Department of Mental Health 41,889,092 State Department of Health Children's First 2,613,290 Sooner Start 2,914,702 Early Intervention 5,466,773 EPSDT Clinic 2,426,017 Family Planning 705,159 Family Planning Waiver 4,610,117 Maternity Clinic 186,855 Total Department of Health 18,922,913 County Health Departments EPSDT Clinic 797,589 Family Planning Waiver 22,966 Total County Health Departments 820,555 State Department of Education 216,635 Public Schools 6,481,409 Enhanced Payments 25,152,726 Native American Tribal Agreements 1,530,499 Department of Corrections 177,973 JD McCarty 4,364,382 Total OSA Medicaid Programs $ 868,176,633 OSA Non-Medicaid Programs $ 9,621,066 Account Receivable from OSA $ 13,026,643 Page 3
5 Fund 230: Nursing Facility Quality of Care Fund Total State REVENUES Revenue Share Quality of Care Assessment $ 51,486,120 $ 51,486,120 Interest Earned 67,071 67,071 TOTAL REVENUES $ 51,553,192 $ 51,553,192 FY 09 FY 09 Total EXPENDITURES Total $ YTD State $ YTD State $ Cost Program Costs NF Rate Adjustment $ 137,009,564 $ 46,309,233 Eyeglasses and Dentures 299, ,119 Personal Allowance Increase 3,492,640 1,180,512 Coverage for DME and supplies 2,897, ,348 Coverage of QMB's 1,032, ,071 Part D Phase-In 5,581,182 5,581,182 ICF/MR Rate Adjustment 14,030,589 4,742,339 Acute/MR Adjustments 4,025,883 1,360,748 NET - Soonerride 2,484, ,682 Total Program Costs $ 170,853,527 $ 61,443,235 $ 61,443,235 Administration OHCA Administration Costs $ 481,441 $ 240,720 DHS - 10 Regional Ombudsman 254, ,146 OSDH-NF Inspectors 400, ,000 Mike Fine, CPA 13,000 6,500 Total Administration Costs $ 1,148,587 $ 901,366 $ 901,366 Total Quality of Care Fee Costs $ 172,002,114 $ 62,344,601 TOTAL STATE SHARE OF COSTS $ 62,344,601 Note: Expenditure amounts are for informational purposes only. Actual payments are made from Fund 340. Revenues deposited into the fund are tranferred to Fund 340 to support the costs, not to exceed the calculated state share amount. Page 4
6 Fund 245: Health Employee and Economy Improvement Act Revolving Fund FY 08 FY 09 Total REVENUES Carryover Revenue Revenue Prior Year Balance $ 117,896,571 $ - $ 2,483,589 Tobacco Tax Collections - 45,155,002 45,155,002 Interest Income - 2,956,451 2,956,451 Federal Draws 1,422,201 18,852,124 18,852,124 Transfer to Fund 340 (108,217,090) - - All Kids Act (8,000,000) - - TOTAL REVENUES $ 3,101,682 $ 66,963,577 $ 69,447,166 FY 08 FY 09 EXPENDITURES Expenditures Expenditures Total $ YTD Program Costs: Employer Sponsored Insurance $ 27,940,841 $ 27,940,841 Individual Plan SoonerCare Choice $ 157,189 $ 53,130 Inpatient Hospital 5,680,683 1,920,071 Outpatient Hospital 3,189,031 1,077,893 Behavioral Health - Inpatient Services 3,705 1,252 Behavioral Health - Case Management 59,374 20,068 Physicians 5,997,502 2,027,156 Dentists 3,015 1,019 Other Practitioners 132,582 44,813 Home Health 1, Lab and Radiology 618, ,018 Medical Supplies 310, ,064 Ambulatory Clinics 441, ,304 Prescription Drugs 5,393,230 1,822,912 Miscellaneous 500, ,000 Total Individual Plan $ 22,489,001 $ 7,932,282 Total Program Costs $ 50,429,842 $ 35,873,123 Administrative Costs Salaries $ 1,613 $ 581,010 $ 581,010 Operating Costs 320, , ,662 Contract - Electronic Data Systems 296,171 2,020,467 2,020,467 Total Administrative Costs $ 618,093 $ 3,599,140 $ 3,599,140 Total Expenditures $ 39,472,263 NET CASH BALANCE $ 2,483,589 $ 29,974,903 Page 5
7 Fund 250: Belle Maxine Hilliard Breast and Cervical Cancer Treatment Revolving Fund FY 09 State REVENUES Revenue Share Tobacco Tax Collections 901, ,252 TOTAL REVENUES $ 901,252 FY 09 FY 09 Total EXPENDITURES Total $ YTD State $ YTD State $ Cost Program Costs SoonerCare Choice $ 119,905 $ 28,621 Inpatient Hospital 5,634,425 1,344,937 Outpatient Hospital 4,709,297 1,124,109 Inpatient Free Standing 2, MH Facility Rehab 142,737 34,071 Case Mangement 3, Nursing Facility 11,055 2,639 Physicians 14,864,173 3,548,078 Dentists 230,792 55,090 Other Practitioners 64,004 15,278 Home Health 86,774 20,713 Lab & Radiology 840, ,585 Medical Supplies 324,305 77,412 Ambulatory Clinics 694, ,853 Prescription Drugs 3,531, ,877 Transportation 14,758 3,523 Miscellaneous Medical 121,903 29,098 Total Program Costs $ 31,397,274 $ 7,494,529 $ 7,494,529 TOTAL STATE SHARE OF COSTS $ 7,494,529 Note: Expenditure amounts are for informational purposes only. Actual payments are made from Fund 340. Revenues deposited into the fund are tranferred to Fund 340 to support the costs, not to exceed the calculated state share amount. Page 6
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