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HB 1572 passed this year by the Indiana General Assembly created the Medicaid Managed Care Quality Strategy Committee to focus on standardizing processes under the Medicaid program.
The specific purpose of the new entity is to study:
- Emergency room utilization
- Prior authorization
- Standardization of procedures, forms and service descriptions
- Effectiveness and quality of care
- Numbers of denials by an MCO, reasons for denials, and the number of appeals and overturned denials by each MCO
- How reimbursement rates are determined by MCOs, including rates for emergency room care and neonatal intensive care
Ongoing, informal group discussions on process standardization will be replaced with the formal meetings of this new committee comprised of hospital and physician representatives, as well as officials from the three MCO plans. The committee will likely have two physician members, but the legislatively appointed members have not yet been confirmed.
The committee’s next meeting is set for Monday, Aug. 17.
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| July 20, 2009 e-Reports index>> |
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