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Entries in Medicaid (90)

Thursday
Jun052014

NH DHHS - Changes Coming to MCM Program

Meridian Health Plan Announces Departure

Concord, NH –Meridian Health Plan, one of three Managed Care Organizations

(MCOs) providing benefits under the Medicaid Care Management (MCM) Program,

has chosen to withdraw from the State of New Hampshire effective June 30,

2014. Meridian, based in Detroit, Michigan, requested withdrawal from the

program in order to focus on the growth of its core businesses in the

Midwest. With the addition of the New Hampshire Health Protection Program

coming later this year, Meridian and DHHS agreed that a summer withdrawal

would provide the best opportunity to minimize any disruption to the

Program and its members.



“We will work quickly with the company to develop a transition plan that

protects Meridian members,” said Health and Human Services Commissioner

Nicholas Toumpas. “Meridian’s members and providers can be assured that we

will work very closely with Meridian on how best to transition their

members to our other two MCOs. I want to acknowledge the professionalism

Meridian has shown in all its efforts assisting the Department implement

the first phase of MCM, and in building positive relationships with the

State’s providers.”



Both organizations have affirmed that the top priority in the transition is

the protection of Meridian’s members and the providers who serve them.

Meridian and DHHS are currently collaborating on the details of a

transition plan. Meridian will continue to provide services until July 31,

2014. During the transition period, Meridian members will continue to

receive the same benefits, and Meridian will reimburse its providers for

all services provided to its members through July 31. Further details will

be communicated to all members and providers as they become available.



Meridian was one of New Hampshire’s three MCOs involved in the successful

launch of New Hampshire’s Medicaid Care Management Program back on December

1, 2013. Meridian’s members will be transitioned to one of the remaining

MCOs, New Hampshire Healthy Families or Well Sense Health Plan.



“This has not been an easy decision,” said Dr. David Cotton, Meridian’s

CEO, “but our recent growth in the Midwest demands that we refocus our

resources to continue to provide top-quality managed care products in our

core markets.” Meridian additionally operates Medicaid managed care plans

in Michigan, Illinois, and Iowa. “It has been a privilege to be a part of

the MCM program’s development and to serve the people of New Hampshire.”



New Hampshire Medicaid Care Management members with questions can call the

Department at 603-271-9461. Meridian members may also contact Meridian’s

own Member Services at 855-291-5221, while providers should call Meridian’s

Provider Services at 877-480-8250. Providers may also contact their Network

Development Representative.

Sunday
Feb162014

ALG - Health care compact would restore control of health insurance, Medicare, and Medicaid to states 

6

Feb. 14, 2014, Fairfax, Va.—Americans for Limited Government President Nathan Mehrens today issued the following statement praising Rep. James Lankford for introducing H.J. Res. 110, legislation that would allow states to enter into an interstate compact to regulate health care on their own without federal interference:

"If New York or California like Obamacare, they can keep it. But if other states want out, there should be no reason they cannot administer federal funds the way they see fit. Americans for Limited Government urge every member of the House to cosponsor Lankford's bill to restore state control over health care.

"If states want to opt out of federal administration of health insurance, Medicare, Medicaid, and the insurance exchanges, they should be allowed to. That is what the health compact will accomplish. The compact will transfer federal control of health care to participating states that choose to adopt the compact. It is not mandatory."

To view online: http://getliberty.org/health-care-compact-would-restore-control-of-health-insurance-medicare-and-medicaid-to-states/

Attachments:

H.J. Res 110, Feb. 11, 2014 at http://beta.congress.gov/bill/113th/house-joint-resolution/110/text?q={%22search%22:[%22h%20j%20res%20110%22]}

###

 

Americans for Limited Government is a non-partisan, nationwide network committed to advancing free market reforms, private property rights and core American liberties. For more information on ALG please visit our website at www.GetLiberty.org.

Thursday
Dec122013

NH DHHS Provides Update on MCM Program Transition

Concord, NH – The New Hampshire Department of Health and Human Services

(DHHS) is providing an update on its first full week of the newly launched

Medicaid Care Management (MCM) Program. According to daily call statistics

reported to DHHS by the three contracted health plans, Meridian, NH Healthy

Families and Well Sense, call volume has been what was expected, and issues

that have come up have been quickly resolved. The MCM Program launched

Sunday, December 1, 2013.



“We are pleased with the transition thus far,” said DHHS Commissioner

Nicholas Toumpas. “We had a very thorough implementation plan and the

issues that have come up are the types of things we anticipated and planned

for. That said, we continue to closely monitor daily operations of all

three health plans and our internal processes so that we can take care of

clients and providers needs as they arise.”



The area where there has been some difficulty was with pharmacy claims,

where it is imperative that the pharmacy knows which health plan the

customer has selected in order to process the transaction. DHHS and all 3

health plans did extensive outreach to pharmacies over the past week to

resolve the issue. “Though some instances have required work behind the

scenes to assure continuity of care and timely payment,” said Deputy

Medicaid Director Lisabritt Solsky, “in nearly every such instance, the

challenges were resolved rapidly and the member experience was smooth.”



All MCM participants should now have their health plan identification

cards, but should not discard their Medicaid cards. Many of the issues

that surfaced over the first week of operations should be resolved as a

result of members having their new health plan identification cards.

Provider education and outreach will continue over the coming weeks. Each

health plan operates a member call center where members can call to have

their questions answered; providers with questions should call provider

relations with the respective health plans.



Information about MCM and the Health Plans is available on the DHHS

website: www.dhhs.nh.gov

Wednesday
Dec042013

NH DHHS - Launches MCM Program

Concord, NH – The New Hampshire Department of Health and Human Services

(DHHS) is confirming the new Medicaid Care Management (MCM) Program

launched Sunday, December 1, 2013, as planned. There were no reported

incidents of concern, however, a team of State officials overseeing the

transition was prepared to assist with resolving any issues if they arose.

The team will be in place for the next several weeks to manage issues that

may arise as providers begin seeing MCM patients for scheduled

appointments.



“I am pleased our first two full days of operation have gone smoothly,”

said DHHS Commissioner Nicholas Toumpas. “However, it is too soon to say

what might happen in the coming days, so I’ve asked our MCM implementation

team to remain in place, just in case. Our goal throughout this transition

is to do everything we can to ensure clients and providers a seamless

transition to the greatest extent possible. We will continue to work

toward a smooth transition for the 104,000 or so folks who have

transitioned to MCM.”



Tremendous planning and preparation led up to Sunday’s program launch

including comprehensive readiness review of each of the three Managed Care

Organizations (MCOs), Meridian Health Plan, New Hampshire Healthy Families

Health Plan, and Well Sense Health Plan. State officials and health plan

staff worked through the long Thanksgiving holiday weekend to start the

program Sunday.



Medicaid recipients with scheduled appointments should keep their

appointments and will receive the care they need from their providers.

Beginning Sunday, providers were able to confirm the health plan selection

of their patients through the customary Xerox Enterprise MMIS portal where

they have traditionally confirmed Medicaid eligibility. The function is

enhanced to include both eligibility and health plan selection.



Medicaid recipients with questions about MCM can call Medicaid Client

Services at 1-800-852-3345 ext. 4344. Anyone else with questions can call

1-888-901-4999. Providers with questions can email their questions to:

mcmprovidercontact@dhhs.state.nh.us. It will be checked hourly with

questions being referred to appropriate staff for resolution.



Information about MCM and the Health Plans is available on the DHHS

website: www.dhhs.nh.gov .

 

Thursday
Nov282013

NH DHHS Prepares For Transition to NH’s Medicaid Care Management Program

Concord, NH – The New Hampshire Department of Health and Human Services

(DHHS) is announcing the transition to its new Medicaid Care Management

(MCM) Program on Sunday, December 1, 2013. DHHS is transitioning to MCM

from its current fee-for-service system.



“The transition to MCM has been a significant undertaking, and in fact one

of the biggest public policy initiatives in our State’s history,” said DHHS

Commissioner Nick Toumpas. “Our goal in implementing MCM has been to

improve quality of care and overall health status of those we serve, while

at the same time reducing healthcare costs.”



As of November 22nd, more than 90,000 Medicaid clients were enrolled in the

MCM Program. Medicaid clients started enrolling in MCM in September, which

involved selecting one of three Health Plans, Meridian Health Plan of New

Hampshire, New Hampshire Healthy Families, and WellSense.



Clients have until the end of the day today, November 27th, to make a

change to their Health Plan to be effective for the December 1st start

date. The change needs to be completed by calling the Enrollment Call

Center at 1-888-901-4999 or online via NHEasy at www.nheasy.nh.gov  by 4:00

PM. Health Plan changes made after November 27th will be effective January

1, 2014. As of December 1st, MCM clients will be working directly with the

Health Plan they are enrolled with.



While DHHS is transitioning to MCM, the benefits clients receive will stay

the same. Medicaid providers will continue care for clients without any

interruption of services or payments.



Any Medicaid clients not currently enrolled in the MCM Program will

continue to receive services as they have in the past.



Information about MCM and the Health Plans is available on the DHHS

website: www.dhhs.nh.gov