Throughout the spring and fall, Manatt will be presenting a new series of webinars focused on Medicaid managed care trends, issues and strategies. Sign up today for the sessions of your choice. Even if you can’t make the original airings, register free now, and you will receive an on-demand link to view the programs at your convenience.
“Redefining Care Management in Medicaid Managed Care”—May 24, 3:00–4:00 p.m. ET
States are becoming increasingly demanding in their expectations of Managed Care Organizations (MCOs) when it comes to care management. In what was formerly a domain solely left to MCOs, many states are pushing health plans to move beyond a cubicle-and-telephonic approach, requiring new care management models that have the potential to change the way care is delivered. What does this mean for MCOs, providers and patients? How have these new requirements been reflected in state contracts with MCOs? What opportunities and challenges does this create for both small practices and provider-led organizations, such as Accountable Care Organizations and Clinically Integrated Networks?
Find out in a new Manatt webinar, “Redefining Care Management in Medicaid Managed Care.” The first program in our new series on Medicaid managed care trends, the session will share new perspectives and developments reshaping the market. Key topics include:
- An overview of evolving care management standards for MCOs across states
- Shifting state, plan and provider expectations around accountability, particularly for high-risk populations
- A discussion of how providers can position themselves to take on new care management opportunities—what’s in it for them and what the risks are
- Observations for the future, including the blurring of roles, states’ evolving views of where care management functions should be performed, and opportunities arising for all entities to rethink their roles and develop new models
Presenters:
Benjamin K. Chu, MD, Managing Director, Manatt Health
Melinda Dutton, Partner, Manatt Health
Sharon Woda, Managing Director, Manatt Health
Edith Coakley Stowe, Senior Manager, Manatt Health
“Supporting Children with Special Healthcare Needs in Medicaid Managed Care”—June 20, 1:00–2:00 p.m. ET
States are increasingly enrolling children with complex physical and behavioral healthcare needs, including children in foster care and those receiving waiver services, in Medicaid managed care. Many of these states are expecting more of their contracted managed care plans to ensure vulnerable children’s needs are addressed through the managed care delivery system. Which states have robust requirements in place—and what themes are emerging? Find out in a new Manatt webinar, “Supporting Children with Special Healthcare Needs in Medicaid Managed Care”—the second in our Medicaid managed care series.
The webinar will review the evolving managed care standards for children with special healthcare needs across states, including:
- Requirements for enhanced, coordinated and person-centered care management for children with special healthcare needs who have acute and chronic physical and/or behavioral health needs
- Staffing requirements to ensure plans have specialized experts on hand and are equipped to address emergent and urgent needs, including service utilization approvals
- Transition protocols to support children moving from one plan or care setting to another without gaps in care
- Specialized network adequacy requirements with an emphasis on pediatric specialists and subspecialists
Presenters:
Melinda Dutton, Partner, Manatt Health
Kinda Serafi, Counsel, Manatt Health
“Strategies for Compliance Oversight and Program Integrity in Medicaid Managed Care”—June 27, 1:00–2:00 p.m. ET
There is a growing trend among states to develop more rigorous methods for overseeing and enforcing contract requirements with Medicaid managed care organizations (MCOs). Many states have increased their use of liquidated damages, as well as created financial incentives for plans to make fraud referrals or participate in fraud and abuse investigations and recovery processes. States often report, however, legislative and regulatory obstacles to exercising their authority. This trend has impacted the way MCOs must conduct oversight and has downstream effects on providers.
In a new Manatt webinar—the third in our Medicaid managed care series—we explore the differences and similarities among states in enforcing Medicaid MCO contract requirements. We also examine expectations regarding MCOs’ participation in program integrity activities and the impact on MCOs and providers. Key topics covered include:
- An overview of states’ approaches to compliance oversight and program integrity of Medicaid MCOs
- The impact of compliance oversight and program integrity on rate-setting for Medicaid MCOs
- Barriers to states and MCOs coordinating program integrity activities
- A discussion of how plans can prepare for increased oversight and program integrity activity—and avoid the imposition of liquidated damages
- A look at the impact of plans’ enhanced oversight of providers
- An analysis of how value-based purchasing may alter compliance and program integrity priorities and activities
Presenters:
Randi Seigel, Partner, Manatt Health
Anthony Fiori, Managing Director, Manatt Health