UCHC-AAUP, and the other unions of SEBAC, were notified that due to persistent complaints filed with the Care Management Solutions (CMC) call center, the deadline for state employee (and enrolled dependents) compliance of preventative and chronic illness requirements was extended to February 28, 2014. Members continue to experience frustration with their verification of compliance with the website and when calling the call center. We were recently given a list of members that were non-compliant. The following was recently released by the Comptrollers Office:

“Due to the high volume of direct compliance reports coming in per day (over 900) and calls (1,500-2,000)  CMS has informed me that we cannot rely on the noncompliance list being completely synched up with claims , calls, PNFs and attestations until the 27th .  At this point I am concerned that if your reps start contacting people based on the current list they will reach a significant number of people who have complied by either getting the service, sending in the forms, or calling in to speak with a nurse.  I would advise waiting until the new list comes out if you can.”

We are waiting for the new list. But a couple of things that you should remember. The non-compliance data is unreliable and not up to date. And no matter what the non-compliance list says, no removal from the HEP can occur until the May Healthcare Containment Committee (HCCC) meeting, and can only occur with an affirmative vote of the HCCC or with SEBAC being overruled by an arbitrator.

To assist you further, the HEP call center at CMS has extended its hours and will now be open from 7:00 a.m. to 7:00 p.m. Mondays through Fridays. The call center may be reached at 877-687-1448.

For more information:

Comptrollers Email to State Employees

HEP Physicians Notification Form

HEP Requirements