Painful Price, Potential Promise: Using Analytics to Combat Compound Rx Fraud
The cost of compound pharmaceuticals continues to skyrocket – as much as 18 times what it was just three years ago. Our healthcare system has left the door open for these high price tags and for the unscrupulous to prey on the vulnerable with “miracle cures” or useless dietary supplements. The schemes are endless, with significant risks to patients and their loved ones, even resulting in death.
Learn more about the issue in this webinar:
Presenters: Bill Mahon, president, The MAHON Consulting Group;
and Jean Lyon, RN, MS, vice president of product innovation, HMS
Adventures in Change: Navigating the Affordable Care Act’s Effect on Medicaid Coordination of Benefits
Dec. 7, 2016
The Affordable Care Act (ACA) changed the landscape of Medicaid eligibility and enrollment, forcing Medicaid agencies and health plans to reexamine how to best maximize funding sources to provide care for new populations. Six years after the ACA’s implementation, Medicaid programs still face a dynamic environment in ensuring Medicaid remains the payer of last resort.
Based on this popular MHPA2016 breakout session and new research including both the perspectives of Medicaid MCOs and Medicaid consultants, join us for:
Adventures in Change
Navigating the Affordable Care Act’s Effect on Medicaid Coordination of Benefits
Presenters: Kristen Ballantine, HMS Vice President, Government Relations AND Frank Mincieli, HMS Senior Director, Enterprise Data Quality
This webinar will address:
- How Medicaid expansion demographic changes effect coordination of benefits activities, including demographics and the employer market
- The impact of data sharing initiatives on Medicaid coordination of benefits efforts
- How legislation such as state-level Deficit Reduction Acts provide Medicaid plans more data access and savings opportunities
- Best practices in coordination of benefits post the ACA
- How the 2016 CMS Medicaid Managed Care rule will impact the way plans share data and coordinate benefits
Best Practices for a Medical Plan Audit – A Hospital, a Consultant, and a Vendor
Oct. 24, 2016
This webinar reviews each step of a medical plan audit and highlights the important impact it can have for employers with self-funded health plans.
Featuring input from Johns Hopkins All Children’s Hospital, which conducted a medical plan audit through HMS in 2014 at the recommendation of Bouchard Insurance, the webinar touches on some of the key aspects of an audit, including the financial impact it can have for self-funded employers and its critical role as a trust-building tool.
Medical plan audits offer peace of mind and solidify the ongoing business relationship between an employer and an insurance carrier by verifying accurate claims processing for both parties.Replay webinar recording.
The New Medicaid Managed Care Rule: Practical Guidance From Multiple Viewpoints
Sept. 27, 2016
Join panelists James Golden of Centers for Medicare and Medicaid Services (CMS), Michael McCoy of New Jersey State Comptroller Office, and Alexander Shekhdar of Medicaid Health Plans of America as they share their expertise and viewpoints related to the recent federal Medicare managed care rule regulation and how it might influence practices and approaches on program integrity.
Moderated by Penny Thompson, former deputy director of CMS’ Centers for Medicaid and CHIP Services and a current commissioner of the Medicaid and CHIP Payment and Access Commission (MACPAC), this 50-minute HMS-sponsored webinar is a recording of an original presentation to attendees at the 32nd annual National Association for Medicaid Program Integrity (NAMPI) Conference in Baltimore, Md.
The goals of this session include:
- Provide overview of the rule’s provisions concerning program and financial integrity
- Promote understanding of what the federal government hopes to accomplish
- Provide insight on how states and plans view the regulations and steps to respond
- Generate discussion and thoughts on how these provisions will affect you
Curing Employee Benefits Blues: Solutions That Work
Mar. 10, 2016
When employee benefits costs weigh you down, lighten your load!
Join David Hines, benefits director of Metropolitan Nashville Public Schools; and Alison Walker, HMS sales manager, as they highlight real-world benefits-saving applications for superintendents, human resources professionals, and other school stakeholders.
The webinar shows how AASA School Solutions partner HMS has helped hundreds of districts recognize significant employee benefits savings through two key solutions:
- Dependent Eligibility Verification
- Medical Plan Audit
Find out how these mainstream approaches save money without changing the level of benefits offered.Replay Webinar Recording
The Painful Side-effects of Opioid Fraud: Fighting the Phantom with Proactive Approaches to Analytics, Investigations, and Partnerships
Mar. 3, 2016
Do opioid abuse investigations leave you with a headache? You’re not alone. During this webinar, Ed Hewitt, HMS program integrity solution consultant, discusses:
- A more proactive approach to analytics, investigations, and partnerships
- New geospatial analytics, fresh methods to curb doctor shopping, and preemptive relationships with pharmacies and other partners to deliver outsized results
- Practical ways to fight opioid fraud — and to help those suffering from addiction