Media Contact:

David Huffman

Director of Operations

Phone: 508-365-7833

Email address: David.Huffman@nescso.org

 

Shrewsbury, MA – January 4, 2018 – Today, the New England States Consortium Systems Organization (NESCSO) announced the formation of a multi-state collaborative effort to conduct electronic asset verification services for determination of eligibility for Medicaid for the Aged, Blind and Disabled (MABD) Programs. The MABD programs include long-term care Medicaid, Medicaid for working people with disabilities and other community based Medicaid programs.

Federal and State Medicaid rules establish financial eligibility criteria which must be met, including asset limits which vary by Medicaid program and household size. CMS has mandated that all states establish an electronic asset verification system (AVS) to request and receive national and local financial institution account data such as checking, savings, CDs, Christmas clubs, IRAs, money markets, etc. Once implemented, AVS will significantly reduce manual processes burden for both worker and applicants.

The AVS collaboration is spearheaded by the State of Vermont, which participated in a rigorous review of the bids and is collaborating with Public Consulting Group, Inc. on the implementation of the electronic AVS. In addition to the AVS system NESCSO has also selected Ocrolus, a technology company that automates the review of financial documents to partner in this multi-state collaborative. Ocrolus’s technology helps states improve efficiencies by streamlining the review of large volumes of financial documents as part of the MABD eligibility review process.

These two collaborative efforts can be utilized as a procurement vehicle by any other agency in the country. For more information about the collaborative please contact Elena Nicolella, NESCSO.

About NESCSO

The New England States Consortium Systems Organization (NESCSO) is a non-profit corporation organized by the New England state health and human service (HHS) agencies and the University of Massachusetts Medical School. NESCSO’s Board is composed of the member states’ HHS secretaries or their designees. NESCSO’s mission is to foster communication and collaboration among its members through information sharing and joint projects. NESCSO seeks to support the needs of the state HHS Secretaries by providing a framework for knowledge exchange in order to maximize policy, program and cost effectiveness. To learn more, visit http://www.nescso.org/

 

Contact:

Elena Nicolella

Executive Director

(401) 952-4369

elena.nicolella@umassmed.edu

 

About Public Consulting Group

Public Consulting Group, Inc. (PCG) is leading public sector management consulting and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986 and headquartered in Boston, Massachusetts, PCG has over 2,000 professionals in more than 50 offices around the US, in Canada and in Europe. PCG’s Health practice offers in-depth programmatic knowledge and regulatory expertise to help state and municipal health agencies respond to regulatory change, improve access to health care, maximize program revenue, improve business processes, and achieve regulatory compliance. Using industry best practices, PCG’s Health team helps organizations deliver quality services with constrained resources to promote improved client outcomes. To learn more, visit http://www.publicconsultinggroup.com/health/.

 

Contact:

Peter Cheeseman

c.207-861-1950

PCheesman@pcgus.com

 

About Ocrolus

Ocrolus is a technology company that automates the review of financial documents. The Company’s products, PerfectAudit and Medicaid-Genius, analyze statements from every financial institution with 99+% accuracy, generating account information, summary analytics and a comprehensive database of transactions. By replacing the tedious and error-prone manual process of analyzing bank statements with hyper-accurate automation, Ocrolus boosts efficiency for professionals across a range of industries.

Additional information about Ocrolus is available at www.ocrolus.com

 

Contact:

Victoria Meakin

Co-Founder and President

vmeakin@ocrolus.com

o: 646.850.9090 Ext. 2

c: 917.941.5388

Elena Nicolella, executive director of the New England States Consortium Systems Organization (NESCSO), knows first-hand the importance of eliminating silos in achieving population health goals. As Rhode Island’s Medicaid Director from 2009-2013 and director of policy innovation for Rhode Island’s Executive Office of Health and Human Services from 2014-2016, she oversaw numerous efforts that hinged on cross-sector commitments. Now, as head of NESCSO, she is focused on maximizing policy, program, and cost effectiveness across health and human service systems in New England states. CHCS recently spoke with Ms. Nicolella, a former fellow of CHCS’ Medicaid Leadership Institute, about opportunities to foster transformational cross-sector relationships.

 

Read More Here

The Center for Health Care Strategies (CHCS) recently announced that four pairs of state oral health leaders — from Louisiana, Minnesota, Nevada, and Rhode Island — have been chosen to participate in the second cohort of the State Oral Health Leadership Institute. The institute offers a unique opportunity for state Medicaid dental program directors and state oral health program directors to collaborate in pursuit of shared goals. The 10-month leadership program, made possible through the DentaQuest Foundation, will provide state oral health partners with the necessary leadership skills and policy knowledge to improve oral health access and outcomes for low-income children and adults. Two-person teams from each state will create a joint transformation project to address shared oral health goals, and develop their individual leadership competencies through implementation of their project.

Click here to learn more!

The Medicaid Technology Alliance is pleased to provide you with the information presented on the webinar hosted on September 21 at 1:00 EDT.

These materials were all developed with both State and Industry input and are intended to support adoption of Modularity.

 

Meeting Materials:

Webinar Recording

MTA_Deliverables Webinar_09212017

AdvMedIT_Precert MTA Briefing 09_18

Appendix 1 – Model Language and Playbook 8.22.17

MTA Governance Assessment Draft Template v.3_09122017

mta_charter_03222017

MTA_Deliverables Webinar_Draft 09202017

Poplin update 20170918 v2

State and Vendor Modularity Playbook v0.1

State and Vendor Playbook brief

FOR IMMEDIATE RELEASE

March 21, 2017

Contact: Jennifer Rosinski

508-421-5869

Jennifer.rosinski@umassmed.edu

NESCSO and Myers and Stauffer LC survey finds $10.59 is median cost of dispensing medications to Medicaid beneficiaries in New England

 SHREWSBURY, Mass. – A recent survey of New England pharmacies found the median cost to dispense one prescription to a Medicaid beneficiary is $10.59. The survey was completed by the New England States Consortium Systems Organization (NESCSO), a nonprofit organized by the health and human service agencies of the New England states and UMass Medical School, in partnership with the accounting firm of Myers and Stauffer LC.

State Medicaid agencies have been directed by the federal Centers for Medicare and Medicaid Services (CMS) to review the way they pay pharmacies for dispensing medications. New rules released in January 2016 require states to adopt fee-for-service pharmacy payment policies designed to pay pharmacies for the cost of acquiring the drugs as well as an additional professional dispensing fee. The survey results will help each state Medicaid program determine an appropriate professional dispensing fee.

“I am grateful for the effort undertaken by NESCSO to procure a vendor to conduct the cost of dispensing survey for my state and the New England region as a whole,” said Herman Kranc, RPh, medical administration manager, Division of Health Services for the Connecticut Department of Social Services. “The process was organized and efficient, providing a high level of value for my state.”

Efforts to promote survey participation and pharmacy cooperation led to an overall survey response rate of 71.8 percent. Surveys were distributed to approximately 2,900 Medicaid-enrolled pharmacies across New England in early September 2016.

Myers and Stauffer reviewed completed surveys to ensure completeness, accuracy and reasonableness. The average cost of dispensing per prescription for each pharmacy was calculated using appropriate accounting standards. The $10.59 per prescription is the median value, weighted by Medicaid prescription volume.

A comprehensive report detailing the survey methodology as well as regional and state-specific averages for the cost of dispensing prescriptions was provided to NESCSO and member states.

This joint effort of New England states is the first of its kind in the nation. Undertaking a regional survey allows states to save money and time, and provides comparable data.

“I was pleased with how the project was able to move forward in a timely manner given that each of the six states has their own perspectives and needs,” said Margaret A. Clifford, RPh, pharmacy director, Office of Medicaid Services, New Hampshire Department of Health and Human Services.

Read the final regional report here: new_england_2016_cod_report_final

About NESCSO

The New England States Consortium Systems Organization (NESCSO) is a non-profit corporation organized by the New England state health and human service (HHS) agencies and the University of Massachusetts Medical School. NESCSO’s Board is composed of the member states’ HHS secretaries or their designees. NESCSO’s mission is to foster communication and collaboration among its members through information sharing and joint projects. NESCSO seeks to support the needs of the state HHS Secretaries by providing a framework for knowledge exchange in order to maximize policy, program and cost effectiveness.

Annually NESCSO convenes the Medicaid Enterprise Systems Conference and markets “MAGI in the cloud” for states to use in determining income eligibility under the Affordable Care Act.

 

About Myers and Stauffer LC

Myers and Stauffer LC is a Certified Public Accounting firm with 18 offices nationwide and over 700 employees. The firm is strongly focused on assisting government health care agencies with audit, rate-setting, program integrity, consulting and other support services. Since the late 1970’s, Myers and Stauffer has performed over 100 Medicaid pharmacy cost of dispensing surveys in more than 20 states. The firm is also a leader in assisting state Medicaid programs with pharmacy reimbursement based on actual acquisition cost. In addition to working with state Medicaid programs directly on actual acquisition cost reimbursement, Myers and Stauffer has been the contractor to CMS since 2011 to develop and maintain the National Average Drug Acquisition Cost (NADAC) benchmark.

 

About the University of Massachusetts Medical School

The University of Massachusetts Medical School, one of five campuses of the University system, is comprised of the School of Medicine, the Graduate School of Biomedical Sciences, the Graduate School of Nursing, a thriving research enterprise and an innovative public service initiative, Commonwealth Medicine. Its mission is to advance the health of the people of the Commonwealth through pioneering education, research, public service and health care delivery with its clinical partner, UMass Memorial Health Care. In doing so, it has built a reputation as a world-class research institution and as a leader in primary care education. The Medical School attracts more than $249 million annually in research funding, placing it among the top 50 medical schools in the nation. Commonwealth Medicine provides a wide range of care management and consulting services to government agencies and health care organizations.

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In the last few years, hospitals have had to respond to changes in the health care environment. Some of the challenges they’ve faced involve adjustments in Medicare policy, lower rates of uncompensated care, greater experimentation with provider payment reforms by public and private payers, and innovations enabling the delivery of care in ambulatory settings.

To better understand these trends and the changing roles of hospitals, the Milbank Memorial Fund and the New England States Consortium Systems Organization sponsored a one-day forum in October 2016 that brought together state health policy leaders from across New England.

This issue brief was written by Gary Young, JD, PhD, of Northeastern University, who gave a presentation at the conference on the changing environment of hospitals. The brief looks at the ways the Affordable Care Act sought to change hospitals, how hospitals are responding to these pressures, and how state governments can ensure those responses are consistent with efforts to improve population health and health care value.

Hospitals in the Post-ACA Era: Impacts and Responses Issue Brief