HomeMy WebLinkAboutFollow-up of DOC and Onsite PharmacyFollow-up report of Health Benefits Trust - Onsite Clinic and Pharmacy #14/15-3 August 2014
FOLLOW-UP REPORT
Health Benefits Trust – Deschutes Onsite Clinic and Onsite
Pharmacy Performance
(Internal audit report #12/13-11 issued October 2013)
To request this information in an alternate format, please call (541) 330-4674 or send email to David.Givans@Deschutes.org
Deschutes County,
Oregon
David Givans, CPA, CIA, CGMA
Deschutes County Internal Auditor
PO Box 6005
1300 NW Wall St, Suite 200
Bend, OR 97708-6005
(541) 330-4674
David.Givans@Deschutes.og
Audit committee:
Jennifer Welander, Chair - Public member
Chris Earnest - Public member
Gayle McConnell - Public member
Michael Shadrach - Public member
Anthony DeBone, County Commissioner
Nancy Blankenship, County Clerk
Dan Despotopulos, Fair & Expo Director
Follow-up report of Health Benefits Trust - Onsite Clinic and Pharmacy #14/15-3 August 2014
TABLE OF
CONTENTS:
1. INTRODUCTION
1.1. Background ………………………………………...………………................................... 1
1.2. Objectives & Scope ……………………………………..………………………….…….… 1
1.3. Methodology ……………………………………………………..…………………….……. 1
2. FOLLOW-UP RESULTS ……………….…...………………………….............................. 2
3. APPENDIX I – Internal Audit Recommendations - Updated Workplan for
Report #12/13-11 (Status updated as of August 2014) ……...…................................ 3-4
Follow-up report of Health Benefits Trust - Onsite Clinic and Pharmacy #14/15-3 August 2014
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1.
Introduction
1.1 BACKGROUND
Audit Authority:
The Deschutes County Audit Committee has suggested that follow-ups occur from nine months to one
year after the original report issuance. The Audit Committee’s would like to make sure departments
satisfactorily address recommendations.
1.2 OBJECTIVES and SCOPE
Objectives:
The objective was to follow-up on the outstanding audit recommendations.
Scope:
The follow-up included seven (7) recommendations from the internal audit report on Health Benefits Trust –
Deschutes Onsite Clinic and Onsite Pharmacy Performance (#12/13-11) (issued October 2013).
The follow-up reflects the status as of August 2014. The original internal audit report should be referenced
for the full text of recommendations and discussion.
1.3 METHODOLOGY
The follow-up report was developed from information provided by Kathleen Hinman, Benefits Coordinator.
In cases where recommendations have not been implemented, comments were sought for the reasons why
and the timing for addressing these. The follow-up is, by nature, subjective. In determining the status of
recommendations that were followed up, we relied on assertions provided by those involved and did not
attempt to independently verify those assertions.
Since no substantive audit work was performed, Government Auditing Standards issued by the Comptroller
General of the United States were not followed.
DESCHUTES COUNTY
INTERNAL AUDIT
REPORT
DESCHUTES COUNTY
INTERNAL AUDIT
REPORT
DESCHUTES COUNTY
INTERNAL AUDIT
REPORT
Follow-up report of Health Benefits Trust - Onsite Clinic and Pharmacy #14/15-3 August 2014
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2.
Follow-up
Results
Figure I -
How were
recommenda-
tions
implemented?
The follow-up included seven (7) recommendations. Management agreed with all of the recommendations.
Figure I provides an overview of the implementation status of the recommendations. The details of the updated
workplan are provided in Appendix I.
With this follow-up, there has been a reasonable effort in moving items along to completion. Given the new staff in
the Personnel department, it is understood some of these items are still being worked on. Expected completion
dates were provided for all outstanding items.
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3. Appendix Appendix I –Updated Workplan for Report #12/13-2 (Status as of August 2014)
Rec# Recommendation text Agreement
Updated
Status
Expected
Completion
Date Updated Department Comments
1 It is recommended for management
of the Plan to develop and
implement a consistent approach to
assessing the performance of the
DOC.
Agree Planned/ Underway Jan-15 Due to the change in personnel (Benefits Coordinator
and Human Resources Director), the Personnel
Department is working with Medcor and EBMS to create
a better reporting system. Medcor has been able to
provide Procedural Terminology (CPT) codes, which is a
more accurate method of reporting expenses and
savings; however, it does not include the fixed costs
associated with the DOC. This process is labor
intensive and cannot be performed each month and will
be changing the process to report the information
quarterly. Staff has requested Medcor provide service
data that includes fixed costs and shows costs as
compared to community costs.
2 It is recommended for County
management to develop an
approach to handling Plan and
DOC staffing and oversight.
Agree Planned/ Underway Dec-14 Medcor will provide a capacity report to identify staffing
needs. Personnel staff will work with Medcor to develop,
evaluate, and implement the most appropriate staffing
model moving forward.
3 It is recommended for the County to
identify how to better collect
information on employee DOC
visits. It is suggested all employees
be required to indicate on their
timesheets their use of the DOC.
Agree Planned/ Underway Dec-14 Personnel staff worked with Finance to create the
payroll code “AC.” Personnel staff will work with
departments to determine current practices in regards to
recording and paying for time spent at the DOC. Staff
will then work to develop and distribute an educational
message for employees regarding the use of this payroll
code and the guidelines for DOC visits on work time.
Staff will review to see if a policy should be created.
4 It is recommended, after adequate
time sheet information has been
collected, the County assess the
cost to the County and departments
for employee usage of the DOC on
work time and whether they want to
continue the practice at this level.
Agree Planned Jul-15 Personnel staff will review DOC usage during work
hours to assess the impact on the County. The
policy/practice will be reviewed to determine if changes
will need to be made or if the practice will continue.
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Rec# Recommendation text Agreement
Updated
Status
Expected
Completion
Date Updated Department Comments
5 It is recommended for the Plan to
identify the processes and policies
required to charge for use of the
DOC in workers compensation
matters.
Agree Completed/Ongoing Personnel staff continues to charge the worker’s
compensation fund for DOC visits on a regular basis.
Personnel charged the worker’s compensation fund
retroactively to January 2013. Staff will work on
documenting the current practice.
6 It is recommended the Plan
evaluate how the DOC Pharmacy
arrangement is working under
coordination of benefits and
whether the arrangement needs to
be modified.
Agree Completed DOC Pharmacy bills a member's primary insurance first
if Deschutes County Benefit Plan (the Plan) is the
second insurance. Members of the Plan with
secondary insurance will need to submit for
reimbursement to their secondary insurance if eligible.
7 It is recommended for the Plan to
consider sharing the DOC
Pharmacy ingredient pricing with
the Pharmacy Benefit Manager.
Agree Completed Staff reviewed the DOC Pharmacy contract and
determined that we can't share ingredient pricing with
our PBM. This is considered proprietary information and
probably will not be able to get into a contract with any
vendor.
{END OF REPORT}