PIMCC - Prison Inmate Medical Cost Containment - is a medical cost management, educational program dedicated to assisting county prisons with the containment of all costs relating to prison inmate medical expenses. PIMCC's overall goal is to train, educate and provide a quality managed care program which allows the county to choose their own unique medical cost saving program. Since PIMCC started operations in April 1995 participating counties have received unique services which have resulted in new procedures, newly negotiated contracts with medical providers, and cost savings on a variety of medical services, especially on the cost of inmate medications (prescription and nonprescription).
Counties have unlimited liability for most medical costs for prisoners. Many have been struggling to find ways to control these costs, but most have not been able to purchase insurance to cap expenses, nor have they been successful at negotiating significant discounts from service providers.
Program Links
Questions?
Questions concerning our PIMCC program, including requests for an application, should be directed to
Membership Listing
Full PIMCC Members are shown in orange.
Associate PIMCC Members are shown in blue.
Creation of PIMCC
History of PIMCC
In 1994, one county experienced a major medical claim for one of its inmates, and asked its insurance consultants to develop some recommendations for action. After reviewing these recommendations, the county suggested the consultants contact CCAP to see if their ideas could benefit counties across the state. When Cost Management Plus brought the concept for PIMCC to the Association in 1994, the CCAP Board established a special committee to investigate the idea and determine if a program could be developed to assist counties with prison inmate medical costs.
After surveying counties and examining the results and reviewing the concepts proposed by Cost Management Plus, meeting with health care providers, examining potential insurance products, and investigating programs currently being used by counties, the PIMCC Committee unanimously recommended CCAP start the PIMCC program. The CCAP Board of Directors approved the program and its bylaws at their March 19, 1995 meeting.
In March of 2008, an associate member program was introduced to non PIMCC members. This program was developed to provide further assistance in controlling inmate medical costs and evaluation of privatized services. The objective of this program is to “co-create” a service that best fits the county’s needs. These customized services include medical audits, outpatient inmate medical bill audits with monthly medical bill reconciliation reports, case management, contract performance audits and assistance with requests for proposals.
Program Governance
Structure
PIMCC is a separate and independent governmental and legal entity formed by Intergovernmental Agreement by member counties, pursuant to Act 180 of July 12, 1972. The PIMCC Board of Directors is comprised of eleven members. Six Board of Directors are elected by the Member Representatives. At least two shall be representatives of PIMCC Members, and at least two shall be representatives of Act 22 Service Recipients. The remaining five members are appointed by the President of CCAP. One of the five appointments will be an Act 22 Service Recipient. The Governing Board is responsible for the management of PIMCC, as outlined in the PIMCC Bylaws.
PIMCC Service Providers
Most PIMCC services will be provided by Cost Management Plus (CMP). CMP was created to provide administrative services to PIMCC. A managed care consulting firm based in Harrisburg, CMP's primary business is assisting counties with their inmate healthcare needs. Kirsten Bostjanic, President of CMP, can be reached at Cost Management Plus, 2319 Walnut Street, Harrisburg, PA 17103, (800) 552-2752 or (717) 234-6628, fax numbers are (800) 572-2752 or (717) 234-6629.
CCAP provides management services to PIMCC, including accounting, invoicing, marketing assistance, board liaison and other services.
Services
- Complete review of existing medical program and service providers
- Group prescription drug purchasing program
- Drug formulary for physician use
- Auditing of inmate medical bills
- Monthly pharmacy invoice review and trending report
- Periodic on-site visits to discuss trends and program status
- PIMCC Manual with recommended procedures and forms
- Preliminary notification program for outside treatment
- Concurrent review of all hospitalizations
- Subrogation to insurance when applicable
- Overall case management
- Ongoing communication with prison medical personnel
- Electronic newsletter (three per year)
- Assistance in obtaining statewide provider services
- Discount fee negotiations with medical service provider
Act 22
- Act 22 went into effect on July 1, 2011 and caps inpatient hospital care for county and state inmates at Medicaid rates and outpatient care at Medicare rates. Additionally, the Medical Assistance qualification can result in up to 50% of the inpatient care being paid by the federal government. Payment of the inpatient hospital bills is handled through the CCAP PIMCC program, providing the Act 22 Service and acting as a liaison between the counties, DHS and DOC.
- Act 22 Guide: County Prison Inmate Inpatient Registration and Payment
- Act 22 Service at a Glance
- Affordable Care Act and Corrections: New to the National Institute of Corrections website.
- County Prison Inpatient Eligibility Form
- COMPASS Application Screenshot
- Frequently Asked Questions
- Act 22 Overview of Hospital Billed Charges