HWT Completes Second Year of Innovative Program to Help West Virginia's Public Payers Meet the Challenge of Healthcare Overpayments.

Business Editors/Health/Medical Writers

PORTLAND, Maine--(BUSINESS WIRE)--Feb. 2, 2004

HWT, Inc., a leading provider of healthcare overpayment identification and recovery services, announced today that in 2003 it helped the three largest public healthcare payers in West Virginia identify over $21 million in potential healthcare overpayments.

HWT's work supports the State's mission to assure access to appropriate, medically necessary and quality health care services while maintaining accountability for the use of resources. Combined, the three agencies, the Department of Health and Human Resources, Bureau for Medical Services (BMS) which oversees the state Medicaid program, the Public Employee Insurance Agency (PEIA) and the West Virginia Workers' Compensation Commission (WVWCC) represent more than $2B annual expenditures, 550,000 recipients and 1.5 million monthly claims processed.

As of December 2003, the following notable results have been achieved:

-- Across all three programs, a total of 7,944 overpayment

letters for $21 Million have been sent providers

-- An ongoing J-Code Drug Rebate Recovery project has been

implemented that resulted in BMS invoicing an initial $8.3M in

rebates from drug manufacturers

-- PEIA has realized better data integrity and improved

coordination of benefits with WVWCC through the implementation

of new claim edits

-- WVWCC has identified and is in the process of collecting over

$3.3M in claims overpayments

-- HWT's iQSuite(TM) of web-based data mining and analysis

applications has recently been acquired by WVWCC as its

primary decision support system to support claims management,

financial accounting and claims resolution.

In a joint effort commencing late in 2001, the three agencies contracted with HWT to perform post payment review of health claims to identify and recover inappropriately paid funds.

"Working with HWT has allowed us to expand our review capabilities and enhance the complexity of our review criteria," says Jeanne Cress, Director of Surveillance and Utilization Review for Medicaid.

By combining data from three different state agencies and different payments systems, HWT has been able to provide a cross agency perspective on a variety of issues such as determining the appropriate primary payer, duplicate payments to providers from multiple agencies, more effective coordination of benefits among the agencies, practice pattern variation by payer, and poorly performing providers across payment systems.

"HWT has been a real partner and asset for us," Cress states, "The participation of multiple payers has provided West Virginia a unique opportunity to analyze our healthcare payment patterns and trends that we could not have achieved without HWT."

Tammy Vickers, Associate Director, Claims Medical Payment Review commented, "This program is a key step forward in our ability to dramatically improve our payment accuracy. Through HWT's innovative overpayment algorithms and the implementation of new claims edits, West Virginia Workers' Compensation Commission has saved millions of dollars."

"The comprehensive claims analysis and recovery has been a true team effort by HWT, PEIA and Acordia National, our third party administrator. As a result, PEIA has improved internal policies and procedures and identified educational opportunities for our staff and healthcare providers," observed Tanya Cyrus, PEIA's Manager of Health Benefits and Clinical Administration.

HWT uses sophisticated data mining techniques to electronically audit multiple years of claims history representing millions of claims for unusual billing patterns. HWT provides payment accuracy and overpayment recovery services to a number of state Medicaid and public payer programs. HWT's Chief Executive Officer Des Varady commented, "The coordinated effort of the three agencies in West Virginia is the first of its kind and clearly demonstrates that by systematically looking at large volumes of data from multiple state payers, we can gain a unique perspective on cost saving opportunities that are not typically available. These results show West Virginia's commitment to and leadership in addressing healthcare payment integrity."

About HWT

HWT helps healthcare payers use their paid claims data to recover overpayments, address fraud and waste, and implement a wide range of other cost saving programs. Combining advanced technology, industry expertise and proven methods, HWT's products and services enable our clients to find and save money in program integrity, TPL, drug rebate, pharmacy cost control, program financial management and applied advanced technology. For more information, please visit www.hwtc.com or contact Karen Budd at [phone], [e-mail]