Medicaid

Healthfirst Plans Receive 4-Star Rating (out of 5 stars) for 2022 for Third Consecutive Year

Friday, October 15, 2021 - 5:57pm

The rating is based on the quality of, and members satisfaction with, healthcare services in 2020 and early 2021iii.

Key Points: 
  • The rating is based on the quality of, and members satisfaction with, healthcare services in 2020 and early 2021iii.
  • Healthfirst Medicare Advantage plans that received a 4 Star-Rating (out of 5 stars) include:
    Our consistently high star ratings reflect our commitment and ability to deliver superior Medicare Advantage plans to beneficiaries, said Pat Wang, President and CEO of Healthfirst.
  • Our 2022 plans will continue to ensure that members get high-quality care and help them lead a healthier lifestyle.
  • It offers market-leading products to fit every life stage, including Medicaid plans, Medicare Advantage plans, Long-Term Care plans, Qualified Health plans, Essential Plans, and individual and small group plans.

Medical Mutual Medicare Advantage PPO Plans Achieve CMS’ Highest Rating

Friday, October 15, 2021 - 5:35pm

Medical Mutuals preferred provider organization (PPO) line of Medicare Advantage Plans achieved the Centers for Medicare and Medicaid Services (CMS) top rating, 5 out of 5 Stars, for 2022.

Key Points: 
  • Medical Mutuals preferred provider organization (PPO) line of Medicare Advantage Plans achieved the Centers for Medicare and Medicaid Services (CMS) top rating, 5 out of 5 Stars, for 2022.
  • Medical Mutual entered the Medicare Advantage market in 2016, earning the highest enrollment of any new plan that year.
  • The 5-Star rating allows individuals to switch to a Medical Mutual PPO plan anytime throughout the year.
  • In addition, because Medical Mutuals Medicare Advantage plans come with a Medicare Part D Prescription Drug Plan, Medical Mutual was also evaluated on members overall satisfaction with the drug plan, drug pricing and patient safety.

Chicago Attorney Michael I. Behn Spotlights Whistleblowers' Contributions at National Meeting of Medicaid Fraud Prosecutors

Friday, October 15, 2021 - 4:00pm

CHICAGO, Oct. 15, 2021 /PRNewswire-PRWeb/ -- Whistleblowers' lawyer Michael I. Behn of Chicago, Illinois, recently spoke at the annual training conference for the National Association of Medicaid Fraud Control Units (NAMFCU).

Key Points: 
  • CHICAGO, Oct. 15, 2021 /PRNewswire-PRWeb/ -- Whistleblowers' lawyer Michael I. Behn of Chicago, Illinois, recently spoke at the annual training conference for the National Association of Medicaid Fraud Control Units (NAMFCU).
  • "The states have demonstrated powerful leadership in prosecuting Medicaid fraud under state False Claims Acts," said Behn, a former federal prosecutor in New York .
  • Behn has represented whistleblowers in several successful multi-state qui tam actions, which obtained large recoveries for Medicaid fraud.
  • Further details about Behn & Wyetzner, Chartered, qui tam actions, relators, Medicare and Medicaid fraud, pharmaceutical and pharmacy fraud, and procurement fraud can be found at http://www.BehnWyetzner.com .

Palm Medical Centers Names Jim McHugh Chief Financial Officer

Friday, October 15, 2021 - 1:00pm

Palm Medical Centers (PMC), an MBF Healthcare Partners II, L.P. (MBF) portfolio company, has named Jim McHugh as its Chief Financial Officer.

Key Points: 
  • Palm Medical Centers (PMC), an MBF Healthcare Partners II, L.P. (MBF) portfolio company, has named Jim McHugh as its Chief Financial Officer.
  • Jim brings a successful track record of guiding managed care organizations and growing top line revenue, said Fowad Choudhry, CEO of Palm Medical Centers.
  • As Chief Financial Officer of NTSP, Mr. McHugh helped to significantly grow the companys annual revenue, launched Medicare Advantage plans in Fort Worth and North Carolina, and served as Chief Financial Officer of a CMS Medicare Pioneer ACO.
  • Partnering with numerous managed care organizations, Palm Medical Centers offers comprehensive and integrated medical care to plan members with a focus on quality.

$100,000 MolinaCares Accord Grant Creates New Partnership with Valley Leadership in Support of Re-Entry Focused Employment Programs in Arizona

Thursday, October 14, 2021 - 6:29pm

The MolinaCares partnership with Valley Leadership is focused on fighting that stigma, allowing Arizonans to grow through positive workforce achievement, and we look forward to working with them to make an impact on the community.

Key Points: 
  • The MolinaCares partnership with Valley Leadership is focused on fighting that stigma, allowing Arizonans to grow through positive workforce achievement, and we look forward to working with them to make an impact on the community.
  • Arizonas three-year return-to-prison rate is approximately 40%, but this rate can be reduced when formerly incarcerated individuals find gainful employment.
  • The MolinaCares grant will fund creation of an employer resource toolkit on inclusive hiring criteria.
  • We are so appreciative of MolinaCares for its generous donation, said Dave Brown, chief executive officer of Valley Leadership.

OSF HealthCare joins partnership in SWITCH, a collaboration platform, to address health equity

Thursday, October 14, 2021 - 6:54pm

PEORIA, Ill., Oct. 14, 2021 /PRNewswire/ -- OSF HealthCare joins SWITCH, a new independent organization launched by City Tech Collaborative (City Tech ), a Chicago-based urban solutions accelerator, to address health equity in Chicago.

Key Points: 
  • PEORIA, Ill., Oct. 14, 2021 /PRNewswire/ -- OSF HealthCare joins SWITCH, a new independent organization launched by City Tech Collaborative (City Tech ), a Chicago-based urban solutions accelerator, to address health equity in Chicago.
  • Its mission is to increase health equity and measurably improve community health delivery and wellness outcomes in Chicago's most underserved communities.
  • SWITCH was recently chosen to participate in a 2021 Health Equity Innovation accelerator program to support entrepreneurs with solutions that advance health equity.
  • OSF HealthCare, through OSF Home Care Services, operates an extensive network of home health and hospice services.

First Medical Renews, Expands Partnership With Abarca For Pharmacy Benefit Services

Thursday, October 14, 2021 - 6:43pm

Abarca will guarantee an overall per-script net cost capped at a low annual inflation rate, providing First Medical the drug spend predictability many plan sponsors seek.

Key Points: 
  • Abarca will guarantee an overall per-script net cost capped at a low annual inflation rate, providing First Medical the drug spend predictability many plan sponsors seek.
  • This model is straightforward, transparent, and disruptive to the status quo pricing models that exist in the PBM market today.
  • Under this new agreement, Abarca will continue to provide full PBM services for the plan's commercial lines of business for an additional three years.
  • "We are proud of everything that First Medical and Abarca have been able to accomplish together over the past ten years," concluded Francisco J. Artau Feliciano, president of First Medical Health Plan.

Alpine Investors’ TEAM Services Group Partners With 24 Hour Home Care, a Leading In-Home Care Services Provider

Thursday, October 14, 2021 - 3:00pm

TEAM Services Group (TEAM), a portfolio company of Alpine Investors, announced today that they have partnered with 24 Hour Home Care, an industry-leading provider of non-medical home care to seniors and persons with intellectual and developmental disabilities (I/DD).

Key Points: 
  • TEAM Services Group (TEAM), a portfolio company of Alpine Investors, announced today that they have partnered with 24 Hour Home Care, an industry-leading provider of non-medical home care to seniors and persons with intellectual and developmental disabilities (I/DD).
  • 24 Hour Home Care will continue operating under its brand name within TEAM Public Choices, a division of TEAM that serves clients through Medicaid and other state-sponsored disability programs.
  • We are absolutely thrilled to partner with David, Ryan, Jacque [CFO], and the rest of the 24 Hour Home Care team, said Josh Greenberg, CEO of TEAM Services Group.
  • 24 Hour Home Care is a trusted in-home care company that provides friendly and reliable home care services to seniors and children with disabilities.

In first of its kind study, Prime Therapeutics explores paroxysmal nocturnal hemoglobinuria (PNH) C5 inhibitor treatment rates

Thursday, October 14, 2021 - 2:02pm

EAGAN, Minn., Oct. 14, 2021 /PRNewswire/ --Leading pharmacy benefit manager (PBM) Prime Therapeutics LLC (Prime) used its integrated medical and pharmacy claims data to evaluate paroxysmal nocturnal hemoglobinuria (PNH) C5 inhibitor treatment rates among its commercially insured population.

Key Points: 
  • EAGAN, Minn., Oct. 14, 2021 /PRNewswire/ --Leading pharmacy benefit manager (PBM) Prime Therapeutics LLC (Prime) used its integrated medical and pharmacy claims data to evaluate paroxysmal nocturnal hemoglobinuria (PNH) C5 inhibitor treatment rates among its commercially insured population.
  • "To our knowledge, this is the first real-world claims based PNH C5 inhibitor treatment assessment conducted by a PBM.
  • Baseline clinical characteristics and disease burden in patients with paroxysmal nocturnal hemoglobinuria (PNH): updated analysis from the International PNH Registry.
  • Prime Therapeutics LLC (Prime) helps people get the medicine they need to feel better and live well.

Cognosante Earns 2021 Great Place to Work Certification™ - Outpacing National Average by 26 Points

Thursday, October 14, 2021 - 2:00pm

This year, the company scored 26 points higher than the average U.S. company for employees who rated their workplace as a great place to work.

Key Points: 
  • This year, the company scored 26 points higher than the average U.S. company for employees who rated their workplace as a great place to work.
  • "Great Place to Work Certification isn't something that comes easily it takes ongoing dedication to the employee experience," saidSarah Lewis-Kulin, vice president of global recognition at Great Place to Work.
  • "We are delighted our employees view Cognosante as a Great Place to Work for the second year in a row," said Jennifer Bailey, Cognosante's Chief Administration Officer.
  • According to Great Place to Work research, job seekers are 4.5 times more likely to find a great boss at a Certified great workplace.