Tuesday, July 31, 2012

Delaware's Medicaid News

Since July 1st, the Delaware Medical Assistance Program has been providing telemedicine-delivered services to Medicaid clients for behavioral health and general healthcare services including medical subspecialties not widely available in the state.

Telemedicine services are being reimbursed for telemedicine-delivered services provided by an originating site that is paid a facility fee for the telemedicine space and equipment, with the consulting services reimbursed as if delivered face-to-face.

For services to be covered, both the distant provider and the originating site provider must be enrolled in the Delaware Medical Assistance Program or in one of the program’s managed care organizations.

Also in the state, Christiana Care Health System was awarded $10 million from the Center for Medicare and Medicaid Innovation (CMMI) to help create and test a system that will use a patient care hub and case mangers to improve care for post myocardial infarction and revascularization patients most of which are Medicare or Medicaid beneficiaries.

The system will enable Christiana Care to integrate the statewide health information exchange data with cardiac care registries from the American College of Cardiology and the Society of Thoracic Surgeons. This will enable more effective care and case management through near real- time visibility of patient care events, lab results, and testing.

In addition, Nemours Alfred I. DuPont Hospital for Children received $3,697,300 from CMMI for their “Optimizing Health Outcomes for Children with Asthma in Delaware” project. Nemours is partnering with Delaware Health and Social Services, Division of Medicaid and Medical Assistance and others to fund family-centered health homes to provide services for children with asthma.

The goal of this model is to reduce asthma-related emergency room use and asthma-related hospitalization among pediatric Medicaid patients in the state by 50 percent by 2015 with incremental declines in 2013 and 2014.

It was announced in July that the Delaware Division of Medicaid & Medical Assistance has signed a $50 million agreement for HP to continue to provide Medicaid fiscal-agent services for three years. Under this agreement, HP will continue to manage the state’s Medicaid Management Information System and will continue to provide a wide range of Medicaid services, including pharmacy and medical claims processing eligibility verification, call center support, and administer the state’s drug rebate program.