FINANCIAL REPORT For the Five Months Ended November 30, 2007 Submitted to the CEO & Board January 10, 2008
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1 FINANCIAL REPORT For the Five Months Ended November 30, 2007 Submitted to the CEO & Board January 10, 2008 Revenues for OHCA through November, accounting for receivables, were $1,269,425,174 or.4 % under budget. Expenditures for OHCA, accounting for encumbrances, were $1,219,677,548 or.4% under budget. The state dollar budget variance through November is $8,899,770 positive. In addition to the SFY08 variance, the agency has $10,493,719 in prior year carryover. These funds are being held in reserve for the FY09 budget. The budget variance is primarily attributable to the following (in millions): Expenditures: Medicaid Program Variance 1.5 Administration 3.1 Revenues: Taxes and Fees 2.3 Drug Rebate 1.4 Overpayments/Settlements.6 Total FY 07 Variance $ 8.9 ATTACHMENTS Summary of Revenue and Expenditures: OHCA 1 Medicaid Program Expenditures by Source of Funds 2 Other State Agencies Medicaid Payments 3 Fund 230: Quality of Care Fund Summary 4 Fund 245: Health Employee and Economy Act Revolving Fund 5 Fund 250: Belle Maxine Hilliard Breast and Cervical Cancer Treatment Revolving Fund 6 Fund 255: OHCA Medicaid Program Fund 7
2 Summary of Revenues & Expenditures: OHCA Fiscal Year 2008, for the Five Months Ended November 30, 2007 FY08 FY08 % Over/ REVENUES Budget YTD Actual YTD Variance (Under) State Appropriations $ 328,976,790 $ 328,976,790 $ - 0.0% Federal Funds 797,222, ,013,286 (11,208,795) (1.4)% Tobacco Tax Collections 18,975,828 21,498,331 2,522, % Quality of Care Collections 22,111,778 21,927,988 (183,790) (0.8)% Prior Year Carryover 45,000,262 45,000, % Drug Rebates 42,012,199 46,480,354 4,468, % Supplemental Drug Rebates 1,500,000 1,609, , % Medical Refunds 9,057,501 8,346,305 (711,196) (7.9)% Other Revenues 9,361,737 9,572, , % - TOTAL REVENUES $ 1,274,218,176 $ 1,269,425,174 $ (4,793,002) (0.4)% FY08 FY08 % (Over)/ EXPENDITURES Budget YTD Actual YTD Variance Under ADMINISTRATION - OPERATING $ 16,442,503 $ 14,026,765 $ 2,415, % ADMINISTRATION - CONTRACTS $ 26,389,714 $ 20,082,228 $ 6,307, % MEDICAID PROGRAMS Managed Care: SoonerCare Choice 35,656,131 35,903,474 (247,343) (0.7)% Acute Fee for Service Payments: Hospital Services 357,305, ,530,705 7,774, % Behavioral Health 85,306,930 84,819, , % Physicians 127,274, ,694,959 (420,385) (0.3)% Dentists 54,475,678 56,764,735 (2,289,057) (4.2)% Other Practitioners 14,762,297 17,127,755 (2,365,458) (16.0)% Home Health Care 7,834,065 7,240, , % Lab & Radiology 8,671,156 7,899, , % Medical Supplies 22,621,427 21,009,927 1,611, % Ambulatory Clinics 8,875,166 10,874,672 (1,999,506) (22.5)% Prescription Drugs 136,056, ,175,782 3,880, % Miscellaneous Medical Payments 10,095,754 10,141,494 (45,740) (0.5)% Other Payments: Nursing Facilities 217,949, ,764,718 (2,814,887) (1.3)% ICF-MR Private 23,286,073 23,049, , % Medicare Buy-In 46,745,619 46,807,578 (61,959) (0.1)% Transportation 10,051,815 10,374,983 (323,168) (3.2)% Part D Phase-In Contribution 23,569,604 23,389, , % Total OHCA Medical Programs 1,190,538,103 1,185,568,555 4,969, % OHCA Non-Title XIX Medical Payments % TOTAL OHCA $ 1,233,370,320 $ 1,219,677,548 $ 13,692, % REVENUES OVER/(UNDER) EXPENDITURES $ 40,847,856 $ 49,747,626 $ 8,899,770 Page 1
3 Total Medicaid Program Expenditures by Source of State Funds Fiscal Year Ended 2008, for the Five Months Ended November 30, 2007 Health Care Quality of Medicaid BCC Other State Category of Service Total Authority Care Fund HEEIA Program Fund Revolving Fund Agencies SoonerCare Choice 41,066,206 35,812, ,867 5,162,732 Inpatient Acute Care 292,417, ,491, ,786-17,908,120 2,316,286 23,499,228 Outpatient Acute Care 80,612,193 78,895,211 17, ,699,647 - Behavioral Health - Inpatient 50,631,862 47,090, ,008 3,537,003 Behavioral Health - Outpatient 3,486,364 3,486, Behavioral Health - Clinc 47,508,187 33,975, ,484 13,469,530 Behavioral Health - Case Management 199, , ,022 - Residential Behavioral Management 12,797, ,797,569 Targeted Case Management 11,415, ,415,831 Therapeutic Foster Care Physicians 137,665, ,433,133 24,209-20,785,850 5,451,767 9,970,830 Dentists 56,764,735 53,578, ,105,118 81,415 - Other Practitioners 17,127,755 16,905, , ,620 - Home Health Care 7,240,664 7,212, ,786 - Lab & Radiology 7,899,703 7,604, ,298 - Medical Supplies 21,009,927 19,744,048 1,207, ,596 - Ambulatory Clinics 14,013,717 10,677, ,903 3,139,045 Personal Care Services 4,502, ,502,546 Nursing Facilities 220,764, ,055,504 60,825,434-17,879,378 4,402 - Transportation 10,374,983 9,262,820 1,094,219-10,711 7,233 - GME/IME/DME 49,933, ,933,635 ICF/MR Private 23,049,267 14,982,380 7,697, , ICF/MR Public 35,155, ,155,505 CMS Payments 70,196,664 68,070,985 2,125, Prescription Drugs 132,175, ,533, ,297,320 1,344,950 - Miscellaneous Medical Payments 10,141,494 10,087, ,448 - Home and Community Based Waiver 61,284, ,284,397 Homeward Bound Waiver 40,164, ,164,684 In-Home Support Waiver 10,707, ,707,337 ADvantage Waiver 77,237, ,237,078 Family Planning/Family Planning Waiver 2,551, ,551,667 Premium Assistance* 4,062,257-4,062, Total Medicaid Expenditures 1,554,159,429 1,025,097,509 73,380,277 4,062,257 75,356,037 11,734, ,528,617 * Includes $3,013,859 paid out of Fund 245 Page 2
4 Summary of Revenues & Expenditures: Other State Agencies Fiscal Year 2008, for the Five Months Ended November 30, 2007 FY08 REVENUE Actual YTD Revenues from Other State Agencies $ 100,820,905 Revenues from DHS for TFC Expenditures - Federal Funds 247,427,292 TOTAL REVENUES $ 348,248,197 EXPENDITURES Actual YTD Department of Human Services Home and Community Based Waiver $ 61,284,397 Homeward Bound Waiver 40,164,684 In-Home Support Waivers 10,707,337 ADvantage Waiver 77,237,078 ICF/MR Public 35,155,505 Personal Care 4,502,546 Residential Behavioral Management 10,291,031 Targeted Case Management 7,994,132 Total Department of Human Services 247,336,710 State Employees Physician Payment Capitation Payments 5,162,732 Physician Payments 9,970,831 Total State Employees Physician Payment 15,133,563 Education Payments Graduate Medical Education 14,500,551 Graduate Medical Education - PMTC - Indirect Medical Education 26,811,620 Direct Medical Education 8,621,464 Total Education Payments 49,933,635 Office of Juvenile Affairs Targeted Case Management 1,257,575 Residential Behavioral Management - Foster Care 47,307 Residential Behavioral Management 2,459,231 Total Office of Juvenile Affairs 3,764,113 Department of Mental Health Targeted Case Management 180,933 Hospital 3,537,003 Mental Health Clinics 13,469,530 Total Department of Mental Health 17,187,466 State Department of Health Children's First 785,240 Case Management - Early Intervention 1,854,805 EPSDT Clinic 1,238,496 Family Planning 622,633 Family Planning Waiver 1,929,034 Maternity Clinic 45,744 Total Department of Health 6,475,952 Upper Payment Limit 23,064,290 State Department of Education 1,197,951 Department of Corrections 285,307 Native American Tribal Agreements 149,632 Total OSA Medicaid Programs $ 364,528,619 OSA Non-Medicaid Programs $ 3,928,167 Account Receivable from OSA $ 20,208,589 Page 3
5 SUMMARY OF REVENUES & EXPENDITURES: Fund 230: Nursing Facility Quality of Care Fund Fiscal Year 2008, For the Five Months Ended November 30, 2007 Total State REVENUES Revenue Share Quality of Care Assessment $ 21,897,734 $ 21,897,734 Interest Earned 30,254 30,254 TOTAL REVENUES $ 21,927,988 $ 21,927,988 FY 08 FY 08 Total EXPENDITURES Total $ YTD State $ YTD State $ Cost Program Costs NF Rate Adjustment $ 59,206,804 $ 19,111,956 Eyeglasses and Dentures 129,330 41,748 Personal Allowance Increase 1,489, ,746 Coverage for DME and supplies 1,207, ,711 Coverage of QMB's 430, ,906 Part D Phase-In 2,125, ,169 ICF/MR Rate Adjustment 6,013,227 1,941,070 Acute/MR Adjustments 1,684, ,634 NET - Soonerride 1,094, ,214 Total Program Costs $ 73,380,277 $ 23,687,153 $ 23,687,153 Administration OHCA Administration Costs $ 189,916 $ 94,958 DHS - 10 Regional Ombudsman - - Mike Fine, CPA - - Total Administration Costs $ 189,916 $ 94,958 $ 94,958 Total Quality of Care Fee Costs $ 73,570,193 $ 23,782,111 TOTAL STATE SHARE OF COSTS $ 23,782,111 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 SUMMARY OF REVENUES & EXPENDITURES: Fund 245: Health Employee and Economy Improvement Act Revolving Fund Fiscal Year 2008, for the Five Months Ended November 30, 2007 FY 07 & 06 FY 08 Total REVENUES Carryover Revenue Revenue Prior Year Balance $ 82,009,763 $ - $ 82,009,763 Tobacco Tax Collections - 17,681,955 17,681,955 Interest Income - 1,774,788 1,774,788 Federal Draws - 1,563,417 1,563,417 O-EPIC Premiums Collected - 86,460 86,460 Transfer State Share to Fund 340 (751,963) (751,963) TOTAL REVENUES $ 82,009,763 $ 20,354,657 $ 103,116,383 FY 07 FY 08 EXPENDITURES Expenditures Expenditures Total $ YTD Program Costs: Employer Sponsored Insurance $ 3,013,859 $ 3,013,859 Individual Plan Inpatient Hospital $ 288,576 $ 288,576 Outpatient Hospital 95,842 95,842 Behavioral Health - Case Management 7,816 7,816 Physicians 234, ,990 Dentists - - Other Practitioners 8,782 8,782 Lab and Radiology 44,490 44,490 Medical Supplies 4,762 4,762 Ambulatory Clinics 21,584 21,584 Prescription Drugs 329, ,427 Non-Emergency Transportation 12,129 12,129 Advance 500, ,000 Total Individual Plan $ 1,548,398 $ 1,548,398 Total Program Costs $ 4,562,257 $ 4,562,257 Administrative Costs Salaries $ 1,119 $ 125,751 $ 126,870 Operating Costs 51, , ,502 Contract - Electronic Data Systems 219, , ,988 Total Administrative Costs $ 272,157 $ 868,203 $ 1,140,360 Total Expenditures $ 5,702,617 NET CASH BALANCE $ 97,413,766 Page 5
7 SUMMARY OF REVENUES & EXPENDITURES: Fund 250: Belle Maxine Hilliard Breast and Cervical Cancer Treatment Revolving Fund Fiscal Year 2008, for the Five Months Ended November 30, 2007 FY 08 State REVENUES Revenue Share Tobacco Tax Collections 352, ,832 TOTAL REVENUES $ 352,832 FY 08 FY 08 Total EXPENDITURES Total $ YTD State $ YTD State $ Cost Program Costs SoonerCare Choice $ 90,867 $ 20,263 Inpatient Hospital 2,316, ,532 Outpatient Hospital 1,699, ,021 Inpatient Free Standing 4, MH Facility Rehab 63,484 14,157 Case Mangement 1, Nursing Facility 4, Physicians 5,451,767 1,215,744 Dentists 81,415 18,156 Other Practitioners 36,620 8,166 Home Health 27,786 6,196 Lab & Radiology 295,298 65,851 Medical Supplies 58,596 13,067 Ambulatory Clinics 196,903 43,909 Prescription Drugs 1,344, ,924 Transportation 7,233 1,613 Miscellaneous Medical 54,448 12,142 Department of Education - - Total Program Costs $ 11,734,732 $ 2,616,845 $ 2,616,845 TOTAL STATE SHARE OF COSTS $ 2,616,845 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
8 SUMMARY OF REVENUES & EXPENDITURES: Fund 255: OHCA Medicaid Program Fund Fiscal Year 2008, For the Five Months Ended November 30, 2007 FY 08 FY 07 Total State REVENUES Revenue Share Tobacco Tax Collections 21,145,499 21,145,499 TOTAL REVENUES $ 21,145,499 $ 21,145,499 EXPENDITURES FY 08 FY 08 Total Program Costs: Total $ YTD State $ YTD State $ Cost Adult Dental Services $ 3,105,118 $ 1,002,332 Remove Hospital Day Limit 4,336,900 1,399,951 Hospital Rate Increase - Statewide Median +2% 6,232,895 2,011,979 Increase Physician Visits from 2 to 4 per Month 166,630 53,788 Increase Physician Office Visits/OB Visits to 90% of Medicare 9,578,245 3,091,857 Increase Emergency Room Physician Rates to 90% of Medicare 4,534,805 1,463,835 Pay 50% of Medicare Crossover - Physician/Ambulance/OP 6,506,170 2,100,192 Nursing Facility 7% Rate Increase 14,410,373 4,651,668 Enhanced Drug Benefit for Adults ,250,235 2,663,176 Enhanced Drug Benefit for Waiver Adults ,047,085 2,274,799 TEFRA Services 4,684,715 1,512,226 SoonerRide 10,710 3,457 Replace NSGO UPL Revenues 6,492,155 2,095,668 Total Program Costs $ 75,356,036 $ 24,324,928 $ 24,324,928 TOTAL SHATE SHARE OF COSTS $ 24,324,928 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
OKLAHOMA HEALTH CARE AUTHORITY SUMMARY OF REVENUES & EXPENDITURES: Fund 255: OHCA Medicaid Program Fund For the Fiscal Year Ended June 30, 2009
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
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