Virginia s Medicaid MCO Program

Sep 04, 2012

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Presentation Outline. Why Medicaid Managed CareEligibility EnrollmentServicesWhat If. . . . Richmond Foster Care Pilot. The Richmond Foster Care Medicaid Pilot Program was developed in response to a request from the City to provide more coordinated care for children in foster careThe Department

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Virginia s Medicaid MCO Program

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west virginia governor s highway safety program

Strategic Enforcement Project - 2004. Areas of ConcentrationEnforcement ActivitiesPublic Information and EducationMediaTraining. Goals. Enforcement 1560 Enforcement EventsSobriety CheckpointsSaturation PatrolsDirected PatrolsUnderage Enforcement. Goals. Public Information and Education ActivitiesCivic organizationsEmployersSchoolsGeneral Public.

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Virginia s Medicaid MCO Program

2. Presentation Outline. Why Medicaid Managed CareEligibility EnrollmentServicesWhat If. . . . 3. Richmond Foster Care Pilot. The Richmond Foster Care Medicaid Pilot Program was developed in response to a request from the City to provide more coordinated care for children in foster careThe Depa

548 views • 29 slides

West Virginia Medicaid 2010 Authorization Flowcharts

West Virginia Medicaid 2010 Authorization Flowcharts . Routine Outpatient Preauthorization Request. Provider submits Header File and Service Request to APS. APS sends Header File and Service Request to MBH via FTP. MBH pulls applicable data elements from Header File and Service Request.

256 views • 11 slides

Virginia s

Goal of the Project. Divert 55 individuals who are at imminent risk from nursing home placement and Medicaid spend-down through consumer direction of services provided within a designated monthly allotment of up to $1200 . Objectives of the Project. Design program policies, protocols and toolsIde

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Idaho Medicaid Pharmacy Program

Idaho Medicaid Pharmacy Program. Provider Training. Presenter Title/Department Date. Objectives. Upon completion of this training, participants will be able to

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Medicaid Integrity Program

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West Virginia Medicaid & MHNet

West Virginia Medicaid & MHNet. Presentation Points:. A high level overview of MHNet’s end-to-end processes for WV Medicaid A more detailed workflow of MHNet’s Access to Care process and, specifically, MHNet’s outpatient Access to Care process as it will interface with the incoming APS data

137 views • 12 slides

MassHealth PCC and MCO Program Overview

MassHealth PCC and MCO Program Overview. July 17 , 2012. Table of Contents. Charge and context Background and description of PCC and MCO plans Recent changes to PCC and MCO plans Supporting programs complementing managed care plans PCMHI Asthma bundled payment pilot

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CMS Medicaid Integrity Program

CMS Medicaid Integrity Program. Agenda. Overview of Medicaid Integrity Program Medicaid Integrity Group Task Orders Program Specifics Questions/Discussion. Overview of Medicaid Integrity Program .

410 views • 18 slides

Prescribing and Dispensing Drugs in the Virginia Medicaid PDL Program

Prescribing and Dispensing Drugs in the Virginia Medicaid PDL Program. Profiling/ Report Cards. Education. PDL Deployed Electronically. Dr. Chooses Preferred Drug?. Dr. Diagnoses Condition. Patient Visits Doctor. Start. Preferred Drug?. Dr. Writes Prescription. Patient Visits Pharmacy.

187 views • 2 slides

Medicaid Family Planning Program

Medicaid Family Planning Program. Presented to the Coordination of Care Committee and Consumer Access Subcommittee May 22, 2013. Why we need Medicaid Family Planning .

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Update on PEND and Medicaid MCO Payment Reductions

Update on PEND and Medicaid MCO Payment Reductions. Jake O’Shea, MD, FACEP President, Virginia College of Emergency Physicians. 2 Medicaid Delivery Systems in Va. DMAS (“fee-for-service”) Managed care organizations (MCOs). DMAS Fee-for-service. Completely state run

294 views • 12 slides

Medicaid Integrity Program

Medicaid Integrity Program. … and other issues. The Medicaid Integrity Program. Managed by CMS – not OIG The Medicaid Integrity Group David Frank, Director – former prosecutor Support not supplant state efforts – however, is expected to put a lot of pressure on states to perform

208 views • 5 slides

Medicaid Drug Rebate Program

Medicaid Drug Rebate Program. Medicaid Drug Rebate Program. Created by the Omnibus Budget Reconciliation Act of 1990 (OBRA ‘90) Requires drug manufacturers to enter into a National Rebate Agreement to ensure that their drugs are covered by Medicaid agencies

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South Dakota Medicaid Program

South Dakota Medicaid Program. April 23, 2013. What is Medicaid?. Medicaid is one of the largest healthcare insurers in South Dakota Federal-State partnership governed by Medicaid state plan- agreement with federal government on who is served and what services are covered

388 views • 21 slides

MCO P5060.70

MCO P5060.70. Marine Corps Color Guard Manual. Order from carry.

414 views • 30 slides

Virginia Medicaid Infrastructure Grant

Virginia Medicaid Infrastructure Grant. Business Outreach Projects Objective : Employers become more knowledgeable about accommodations and advantages of hiring persons with disabilities Requires blending and braiding of resources Requires collaboration across grants and programs.

169 views • 6 slides

Virginia Medicaid Waivers: Access and Services

Achieve with Us. Virginia Medicaid Waivers: Access and Services. Debra Holloway Director of Training and Technical Assistance. Different Institution Different Waiver.

636 views • 45 slides

Medicaid Family Planning Program

Medicaid Family Planning Program. Presented to the Coordination of Care Committee and Consumer Access Subcommittee May 22, 2013. Why we need Medicaid Family Planning.

244 views • 10 slides

Right Choices Program A combined MCO Presentation

Right Choices Program A combined MCO Presentation. HP IHCP Provider Seminar October 20, 2010 Indianapolis Marriott East. An independent licensee of the Blue Cross and Blue Shield Association. RCPP0001 (09/10). Right Choices Program Presented by. Kelly Henderson, PharmD, RPh

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MCO

MCO.

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Goal: Virginia Medicaid Preferred Drug List

Virginia Medicaid Preferred Drug List and Other Pharmacy Programs: What You Need To Know Presented by: Department of Medical Assistance Services and First Health Services Corporation. Goal: Virginia Medicaid Preferred Drug List. Provision of: Safe drug therapy Effective drug therapy

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Presentation Transcript

west virginia governor s highway safety program

Virginia s Medicaid MCO Program

West Virginia Medicaid 2010 Authorization Flowcharts

Virginia s

Idaho Medicaid Pharmacy Program

Medicaid Integrity Program

West Virginia Medicaid &amp; MHNet

MassHealth PCC and MCO Program Overview

CMS Medicaid Integrity Program

Prescribing and Dispensing Drugs in the Virginia Medicaid PDL Program

Medicaid Family Planning Program

Update on PEND and Medicaid MCO Payment Reductions

Medicaid Integrity Program

Medicaid Drug Rebate Program

South Dakota Medicaid Program

MCO P5060.70

Virginia Medicaid Infrastructure Grant

Virginia Medicaid Waivers: Access and Services

Medicaid Family Planning Program

Right Choices Program A combined MCO Presentation

MCO

Goal: Virginia Medicaid Preferred Drug List

West Virginia Medicaid & MHNet