2017 TAHP Managed Care Conference & Trade Show

October 23-25, 2017 • Registration Coming Soon!

The 2017 TAHP Managed Care Conference, “Connect. Innovate. Achieve.,” is quickly approaching! The conference will feature Dr. Uwe Reinhardt, one of the nation’s leading authorities on health care economics, plus a high-level roster of dynamic speakers who will be coming together to brainstorm and discuss ways to achieve greater value, affordability, transparency, and accessibility in health care.

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AHIP Health Care Forum

This half-day forum, geared for health care CEOs and their senior leadership teams, is more than a “sit-and-listen” meeting. You’ll engage in intense, roundtable-style conversations about the future of health care. You’ll network with peers from across the nation. You’ll address common challenges and discuss the realm of the possible.

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Medical Directors Forum Coming April 3 & 4, 2017

Make plans now to attend or sponsor our upcoming Medical Directors Forum, April 3 & 4 in Austin! This forum’s topic is “Innovation In Care: Part 1.” • Monday, April 3rd 5:00 p.m. – Networking Reception, Record Room, W hotel, Austin, TX • Tuesday, April 4th 8:30 a.m. – 3:30 p.m. – Medical Directors Forum, W hotel, 200 Lavaca St., Austin, TX • Make plans now to attend! TAHP has secured a block of rooms at the W hotel. Please contact me at pdoner@tahp.org if you will be needing a reservation.

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TAHP Membership

Led by a team of seasoned health care policy and advocacy experts, the Texas Association of Health Plans is the statewide trade association representing health insurers, Medicaid plans, Medicaid Advantage plans, and other related entities in Texas. Experience the benefits of TAHP membership by joining today! Build relationships, promote your services, stay informed, and ensure you are well represented in the halls of the Texas Capitol and throughout the State government.
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Building and Fostering Meaningful Relationships

TAHP hosts events year-round that provide opportunities to network in fun, informal venues with other health insurance and health care executives and professionals, legislators, agency leaders, and Capitols staffers and build meaningful relationships.
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Making a Positive Impact on the People of Texas

In addition to playing an integral role in keeping Texas healthy by covering more than 17 million Texans, the Texas insurance industry yields positive results for the economy—creating jobs and opportunity, and generating significant economic revenue for our State.
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Advocating for a Healthy Texas

The TAHP team is comprised of seasoned policy, government relations, and communications professionals with decades of experience on the state and federal levels. These key staff members successfully strategize, build relationships, and advocate for solutions that will make health care more affordable, more accessible and more valuable for all Texans.
Learn More About TAHP Advocacy and Issues

Latest TAHP News
TAHP, TAB & Others Launch Coalition to Tell the Truth About Freestanding ERs

This week, TAHP, TAB, TALHI, TAHU, and TORCH launched a coalition to raise awareness about freestanding ERs, their exorbitant pricing and misleading a. . . read more Thu, 23 Feb 2017 19:15:07 GMT

HAC Begins Meeting

HAC started meeting this week with presentations by the Legislative Budget Board. On Wednesday the LBB provided an overview of Medicaid. Total Medicai. . . read more Thu, 23 Feb 2017 19:15:06 GMT

Trump Administration Releases Proposed Rule Addressing Market Stabilization Issues

This week HHS released a proposed rule that takes steps aimed at stabilizing the individual and small group health insurance markets. The proposed rul. . . read more Thu, 23 Feb 2017 19:15:05 GMT

Texas Association of Freestanding Emergency Centers Makes False Claims About Underpayments By Insura

The Texas Association of Freestanding Emergency Centers (TAFEC) issued a press release this week claiming 3,400 requests for mediations in Texas are c. . . read more Thu, 23 Feb 2017 19:11:57 GMT

Legislators File Bill Extending Sunset Date of State-Run Medicaid Formulary

HB 1917 (attached) was filed this week by Raymond, Zerwas, and Four Price.  The bill extends the sunset date of the state run VDP Medicaid formul. . . read more Thu, 23 Feb 2017 19:10:20 GMT

HHSC Releases 2017 Fact Book

HHSC has released the Fact Book for 2017, which provides overview of Medicaid programs and caseloads and the 11th Edition of Medicaid/CHIP in Perspect. . . read more Thu, 23 Feb 2017 19:09:03 GMT

CMS Projects Accelerating Health Care Cost Growth

Overall health care spending is expected to rise over the next decade and account for 19.9% of the economy by 2025, with the pace of growth to rise 5.. . . read more Thu, 23 Feb 2017 19:08:38 GMT

Kaiser Releases Interactive Tool to Compare Proposals to Replace ACA

A new interactive tool from the Kaiser Family Foundation enables users to create side-by-side comparisons of major ACA alternative plans, now includin. . . read more Thu, 23 Feb 2017 19:06:02 GMT

AHIP: 20 Million Americans Have Health Savings Accounts

The use of health savings accounts has exploded over the last decade, according to a new survey released by AHIP. Just over 20 million Americans had a. . . read more Thu, 23 Feb 2017 19:05:13 GMT

Reminder/Materials for Visiting Capitol Offices

Just a reminder that TAHP has everything you need to visit Capitol offices and get the word out about legislative priorities, including Session Guides. . . read more Thu, 23 Feb 2017 19:03:38 GMT

House Committee Scheduled Announced

Click here to access the full 85th House Committee Schedule. Below are important hearings happening next week: Monday The House Appropriations Subcom. . . read more Thu, 23 Feb 2017 19:02:25 GMT

FOR IMMEDIATE RELEASE • March 23, 2017

FOR MORE INFO CONTACT: Jessica Sandlin, jsandlin@tahp.org


Texas Medicaid Health Plans Joined by TMA in Taking Major Step To Make Medicaid Simpler, More Efficient for Texas Physicians

AUSTIN—The Texas Association of Health Plans (TAHP) in collaboration with the Texas Medical Association (TMA) today announced a joint effort to reduce red tape and administrative burdens for physicians and health care providers seeking to participate in the Texas Medicaid program. TAHP and TMA have selected Aperture, LLC, for a statewide Credentialing Verification Organization (CVO) contract used by all 20 Medicaid health plans in Texas to streamline the provider credentialing process.

“To date, managed care health plans have made significant strides in transforming the Texas Medicaid program to deliver dramatically improved care and outcomes for patients and reduce costs for the State and taxpayers,” said Jamie Dudensing, TAHP CEO and a former practicing nurse. “Today’s announced CVO marks a significant step forward in streamlining credentialing and making it much easier for providers to participate in the program and see Texans on Medicaid. Medicaid health plans are proud to have initiated this effort, and we look forward to continuing to work with TMA to establish a one-stop-shop for providers that greatly reduces their paperwork burden, ensures a more seamless process, and boosts access to safe, quality care for Texans who rely on Medicaid program for their health care needs.”

“Countless Texas physicians want to care for Medicaid patients, but the barrier of Medicaid’s bureaucratic red tape and administrative burdens simply discourage them,” said Don R. Read, MD, TMA’s president. “We hope simplifying doctors’ credentialing and re-credentialing process will ease the path for more Texas physicians to see Medicaid patients.”

Aperture’s CEO, Charles Falcone, said, “Aperture’s partnership with the TAHP will bring together all credentialing stakeholders in a compliant, efficient, and consistent manner.”  He added, “The Unified Credentialing Program will remove many redundancies and create cost savings in both hard dollars and time compared to legacy methods.”

Background

Medicaid Managed Care: In Texas, private health plans or managed care organizations (MCOs) manage the Medicaid program for the State. The State began transitioning to this approach, called the managed care model, in recent years as an alternative to the former costly and inefficient fee-for-service (FFS) model. The managed care private-market approach drives innovation through flexibility and competition, reduces health care costs, and holds Medicaid health plans accountable for providing access to quality care. It has saved the State and Texas taxpayers $4 billion over a six-year period and is expected to save another $3 billion or more by 2018. Just as important, lives and outcomes are being improved with hospital admissions down 20-to-40% for some of the most common and treatable conditions. A recent study found that access and quality for Texas Medicaid health plan enrollees is better than FFS and comparable to private health coverage.

Provider Credentialing: Through this process, MCOs gather and assess background information on health care providers in an effort to confirm the provider is in good standing, ensure patient safety, and prevent fraud, waste and abuse. As it stands, each MCO gathers this background information from providers separately and with varying deadlines, requiring providers to submit and re-submit their information to all 20 Medicaid health plans individually and at different times.

CVO: Texas Medicaid health plans brainstormed on how to simplify this process for physicians and providers and make Medicaid a more welcoming program for quality providers to participate in and provide care to Texas patients. The health plans proposed a statewide CVO concept, which was endorsed during the 84th Texas Legislature in SB 200, jointly authored by Senators Nelson, Birdwell, Campbell, Hinojosa and Schwertner as well as Representatives Price, Raymond, Dutton, Burkett and Larry Gonzales.  The bill established a vision for Texas to streamline the Medicaid provider credentialing process.

How it Works: Simplification of the credentialing process be achieved in several ways. First, there will be a single source for all credentialing information.  That means that if a physician or provider in an area of the state wishes to participate in the network of several health plans in that area then the provider information need only be collected once and is then shared with all of the plans.  Second, the Texas Medicaid health plans elected to adopt a single re-credentialing date.  That means that when a physician must be re-credentialed, generally a process that occurs every three years, the doctor will be re-credentialed once—for all of the participating plans.  Again, this reduces the Medicaid provider hassle factor.  Dudensing added that she is hopeful health plans will include additional lines of business such as commercial insurance and Medicare to the CVO project to further simplify healthcare administration in Texas.

The project implementation will begin immediately with  statewide operations expected to begin October 2017.

About Texas Association of Health Plans (TAHP)

TAHP is the statewide trade association representing health insurers, health maintenance organizations, and other related healthcare entities operating in Texas.  The association was founded in 1987, and represents the healthcare industry’s commitment to improving healthcare for Texans. Contact Laurie Vanhoose, Director of Policy, Government Programs at www.tahp.org or Lvanhoose@tahp.org.

About TMA

TMA is the largest state medical society in the nation, representing more than 50,000 physician and medical student members. It is located in Austin and has 110 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans.

About Aperture Credentialing, LLC

Aperture is the nation’s largest Credentials Verification Organization providing services to some of the largest payer and provider organizations in the country.  Aperture operates nationwide and also manages several other national, state-based and specialty-based unified credentialing programs.  In addition, Aperture’s CredentialSmart software enables provider organizations to manage their end-to-end provider delegation, enrollment, privileging, and credentialing needs. Aperture is NCQA Certified and URAC Accredited for more than 10 years. Contact Michael Moore, SVP Sales, at Mmoore@aperturecvo.com or find more at www.aperturecvo.com.

Amerigroup Texas Names Health Plan President

Amerigroup Texas Names Health Plan President TAHP Member Amerigroup Texas last week announced Tisch Scott has been named health plan president, effective immediately. Scott, a 24-year industry veteran, succeeds LeAnn Behrens who was recently named president of the...

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BCBS TX Names New President

BCBS TX Names New President Blue Cross and Blue Shield of Texas has named Dr. Dan McCoy president, effective July 1, succeeding Bert Marshall, who will retire. Marshall is retiring after 20 years with the company, during which he also served as president of Blue Cross...

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