15th Annual Medicaid Managed Care Congress

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Home»Events»15th Annual Medicaid...Event Overview»Workshops

15th Annual Medicaid Managed Care Congress

June 13 - 15, 2007 | Baltimore Marriott Waterfront, Baltimore, MD

Workshops

June 13, 2007

B1: Full Day Symposium:
Improve Financial & Quality Outcomes by Learning How to Operationalize the Deficit Reduction Act

The Deficit Reduction Act, signed into law on February 8, 2006, sets forth several changes in Medicaid policy that are anticipated to affect almost all elements of the Medicaid program, including eligibility, benefits and cost-sharing, provider payments and program integrity. There is an opportunity for the DRA to improve quality, access and cost effectiveness of care. This symposium teaches how the DRA can work for you:

Part I: Overview

What are the new flexibilities the States have now that they didn't have before?
How are States instituting and reacting to new Medicaid eligibility requirements?
Under the DRA, is there room for a more consumerist approach to Medicaid Managed Care?

Part II: Coordination of States and Plans

What are the new integrity and reporting requirements placed upon States and MCO's?
What is the role for Medicaid plans within overall State healthcare reform initiatives?

Part III: The Impact of the DRA on Quality of Care

How is the DRA improving the quality of care?
How successful have the States been in expanding benefits under the DRA, or have they had to cut benefits?

Part IV: Financial Outcomes of the DRA on State Medicaid Decisions

What cost sharing opportunities are presented by the Deficit Reduction Act?
How can the States invoke penalties, and on whom, under the Deficit Reduction Act?
What effect does the DRA have on waiver programs?

Workshop Leaders:
Shannon R. Turner, JD, Executive Vice President, UNIVERSITY HEALTH CARE
Melodie Shrader, Partner, CONSULTING STRATEGIES TEAM

Who Should Attend:
Executives from State Medicaid Offices and Medicaid Managed Care Plans responsible for eligibility oversight, government programs and policy

B2: AM Workshop

A How To Guide on Beneficiary Education to Increase Quality, Reduce Costs & Streamline Care

Member education is a key component in creating value to the Medicaid Managed Care system. Since the beneficiary population for this group is continuously challenging to manage, health plan administrators must develop creative ways to educate and beneficiaries to take an active role in health management. The workshop leaders share best practices in beneficiary education. Attendees will receive hands-on training and participate in role-playing to build effective tools for member engagement.

How to educate the beneficiary or caregiver as to the different kinds of services available
Whose job is it to educate members and caregivers?
What kinds of services, in addition to medical treatment, are available?
- Social Assistance Services
- Transportation
- Childcare
Implementation and Outcomes of the Personal Care Model at AmeriChoice
How to develop a reference library for referrals and resources for the beneficiary
How to share the financial burden of medical care with the beneficiary without compromising quality

Workshop Leaders:
Judy Shinogle, Health Economist & Assistant Professor, UNIVERSITY OF MARYLAND, DEPARTMENT OF PUBLIC & COMMUNITY HEALTH, AMERICHOICE
Ashish Abraham, MD, MBA, Senior VP for MSO Programs & Health Services, AMERICHOICE
Allen Finkelstein, Chief Dental Officer, AMERICHOICE / UNITED

Who Should Attend:
Executives from State Medicaid Offices and Medicaid Managed Care Plans responsible for quality, branding, marketing, outreach and member education & retention

B3: PM Workshop

What you Need to Know about Medicaid Managed Care Compliance Programs

The False Claims Act, under the DRA, provides financial encouragement to states to adopt laws dealing with false or fraudulent claims, as required by the federal government. As an incentive, the share owed to the federal government will be decreased by 10 percentage points. This workshop covers critical steps on how to implement and manage successful compliance programs within a managed care environment, how to assess and prioritize vulnerabilities, and how to conduct internal compliance audits.

How can investment in compliance programs pay off?
How do compliance programs target high risk areas?
What areas are at greatest risk under the False Claims Act?
How to conduct internal compliance audits in Medicaid Managed Care organizations
How to interpret regulations and standards that contain subjective definitions
How to reconcile Federal & State regulations

Workshop Leaders:
Adam J. Falk, Esq., Compliance Officer, FELDESMAN TUCKER LEIFER FIDELL LLP
Maryann Schwab, CHC, Vice President of Compliance and Risk Management, COMMUNITY HEALTH PLAN

Who Should Attend:
Executives responsible for government policy relations, contracting and compliance such as Compliance Officers, Policy Directors and Directors of Government Relations and Contracting at State Medicaid Agencies and Managed Care Organizations