The Brownsville Independent School District is struggling with understanding health care financing. Poor record keeping, inconsistancies between consultant recommendations, contracts and billing statements have raised questions among local taxpayers.
Once told that the BISD “saved” $9,000,000 moving from the HealthSmart PPO network to the Texas True Choice PPO network, it now appears that the purported savings are questionable.
It is our opinion that there is little if any difference in pricing between the two networks. We ran 100% of claims for one large Valley based employer through both network’s contracts. There was less than a 1% pricing differential. That is pretty conclusive evidence, in our opinion, that neither network has an advantage over the other.
There appears to be little accountability within the BISD self-funded health plan. Records are incomplete, and inconsistant. In 2009 we brought this up to the attention of the BISD Superintendent of Schools with documentation. We showed the differences between the BISD consultant’s recommendations versus actual contracts signed by school officials. We showed the differences between contracts and billing statements. We questioned hundreds of thousands of dollars of apparent descrepancies.
To date, and to the best of our knowledge, these questions remain unanswered by the BISD administration.
Until now…………………..The BISD Board of Trustees has hired an expert forensic auditor to review the BISD self-funded program. We look foward to answers to some of our previously raised questions.
Editor’s Note: Why is BISD still paying run-off claim administration fees? Where is the $2.43 Rx rebate credit that were to be paid to MAA and then credited against future payments made by BISD to MAA? Why did stop loss insurance commissions increase 50% effective 10/01/2009? Why was there a $371,349.36 difference between total fixed cost presented on the consultant’s spreadsheet given to the BISD Board of Trustees versus contracted fixed costs? What fees make up the MAA global administration fee? Why do the totals appear to differ when adding up the various fees? Why does the MAA contract appear to list some of the components of the fees but may omit other components of the fees? We asked BISD to review our findings for accuracy in 2009. We are still waiting for answers to these questions and more.