Connecticut
Medicaid Managed Care Council

Quality Assurance Subcommittee

Legislative Office Building Room 3000, Hartford CT 06106
(860) 240-0321 Info Line (860) 240-8329 FAX (860) 240-8307
www.cga.state.ct.us/ph/medicaid

 


Meeting Summary of Obesity Work Group:  March 18, 2004

Chair:  Paula Armbruster

(Next meeting: Work Group @ 9:30 on 4/15, followed by QA SC @ 10:30 AM in LOB RM 2600)

 

HUSKY Provider Obesity Service Matrix

·        Clarify (Anthem and CHNCT) that obesity-related services in HUSKY A, under EPSDT medical necessity, are not predicated on evidence of co-morbidities, but on medically necessary assessments/interventions by the health practitioner.  The EPSDT medical necessity would not apply to HUSKY B children nor to HUSKY A adults.

·        Dr. Geertsma encouraged the MCOs to apply strict criteria for authorization for gastric surgery for members <18 years; consider criteria for mental health assessment as well.

·        Editing changes were made per the suggestions of the work group. The matrices will be ready for the 4/15 meeting.  Dr. Geertsma suggested Council staff contact the AAP Ex. Dir. as to how this information can best be disseminated to AAP providers.

 

Obesity-Related Legislation:  Elizabeth Brown, Commission on Children

Elizabeth Brown reviewed SB 357: An Act concerning Childhood Obesity.   One part of the bill provides for 3 school-based pilots for the assessment of diabetes and BMI on the school physical form.  Subcommittee participants suggested amending the pilot language to be less prescriptive and several members agreed to contact towns to gauge their interest in participating I the pilot. 

(Addendum: On April 8, the Education Committee reported favorably on a substitute bill 357, file no.520 that does not include the school pilots but provides for physical activity daily/weekly in grades K-5, makes available the purchase of dairy products, water on school site, expands the federal school breakfast program to schools grades 8 and below in which at least forty % of students are eligible for free or reduced lunches).

 

Other

The Work Group participants and QA subcommittee, which include MCOs, state agencies, providers, commission on Children representative, will develop basic pediatric obesity recommendations. Dr. Geertsma and Dr. Karen Dorsey will take the lead on this.

 

The importance of early intervention at age 2-4 years through parental anticipatory guidance in preventing parent/child behavioral patterns that may lead to obesity has been noted several times in the work group.  Will request that DPH bring their expertise to this topic and consider how this might fit into their early Childhood Partners program.

 

 

File: QA SC & Obesity Mar-04

 

Meeting summary: Quality Assurance Subcommittee – March 18, 2004

Chair:  Paula Armbruster

(Next meeting:  Thursday April 15 at 10:30 Am LOB RM 2600)

QA Focus Issues

·        Agreement for regular reports from MCOs on child/adult hospital & ED utilization rates, identifying the top primary diagnoses that would provide the application of a broader public health perspective, particularly for adult health issues.  The DPH sent the 1998 CHIME data reports that could provide a baseline comparison.

 

·        Annual MCO report on appropriate use of asthma medications based on the current HEDIS measure (see attachment from Judi Greene, CHNCT).

o       Suggestion to contact John Farrell about their software system that can produce data in response to specific queries. (Spoke with Mr. Farrell: this system is proprietary, but the capacity of the system could be discussed in the future).

 

·        Continued focus on obesity in HUSKY population, and adolescent health.  Regarding the latter, the MCOs will provide a brief overview of their adolescent projects at the April 16 Medicaid Council meeting.

o       The MCOs will develop action plans for improving the delivery of adolescent health, which was requested of the DSS by the Medicaid Council. (The contract requires MCOs to submit a plan that includes measures to increase the volume of well care adolescent screens and improvement of the quality and completeness of these screens, based on AAP guidelines. Emphasis should be on improving health risk assessments and anticipatory guidance during the visits.  The MCOs will work with the DSS and representatives of other state agencies to develop a best practice model for adolescent care).

o       Maureen Fiore (Health Net) sent us  this great web site, which includes adolescent preventive care  & risk assessment recommendations, anticipatory guidance items. Access this at: www.intermountainhealth.org   find specific items under hospital, clinic, services.

o       The subcommittee will organize a meeting with the MCOs, DSS, and interested HUSKY adolescent practitioners to 1) review and discuss the MCO adolescent pilots and 2) review and comment on the expanded teen anticipatory guidelines that would be added to the state EPSDT form.

 

The QA subcommittee will meet Thursday April 15, 10:30 AM in LOB RM 2600