STORY ON HHSC VISIT TO VALLEY!

STORY ON HHSC COMMISSIONER VISIT TO VALLEY!!!

SUNDAY SEPTEMBER 25TH.

State prepping for Valley’s managed care rollout | care, rollout, managed -

TheMonitor.com       CLIC LINK>>> http://shar.es/HLr8p

WORKING HARD FOR YOU!

The Texas Healthcare Advocacy Association and State Rep. Martinez, Dist 39, thank you for attending the meeting with HHSC Commissioner Suehs at our offices. If you were unable to attend, please visit our website for a summary of this meeting.

 Visit us at : www.texashaa.org Our website also describes our mission, goals, and benefits to its members. There you can also view our past events, videos, pictures and general news of our hard work

The Valley health care community is about to experience a total change in our health care delivery system. Managed care organizations (MCOs also known as HMOs) will be coming to the10 county Hidalgo Service Area. Health care as we know it is about to change come March 2012.

Our Association (THAA) is at the forefront of these changes. We have been working hard since the last Legislative session.

 We are continuing our mission … to promote, educate, inform and advocate for all health care providers.

This meeting was a result of our concern with the rollout in our area.

We are currently planning with HHSC Chairman, Richard Pena Raymond, Dist 42 to begin a series of “public hearings” concerning health care and many other issues that are critical to Texas and in particular South Texas and the border area. We believe that we must begin to advocate now, to make a difference at the next Legislative session. We will be posting these hearing dates at our website: www.texashaa.org ; please check regularly for updates. .

 Our Association is only as strong as its membership. We are committed to working hard for you! We have a proven track record of bringing federal and state elected officials to hear our concerns at our front doors! And we want to continue however, we need your help. Our membership base must be increased in order to meet our rising costs. We can’t do it alone. You can provide your support by JOINING our Association NOW!

We need pro active health providers, agencies, like you, to become Members!

o Together we have a louder VOICE!

o Together we can Make a Difference!

o Together we can do MORE!

 Won’t you help and JOIN our Association NOW?

Just CLICK on MEMBERSHIP button and request our Membership Application at our website. Then complete and submitt your Annual Dues and become a full member! Your dues are tax deductible and can be paid in TWO installments!!!

Please JOIN NOW and together, we can begin to promote, educate, inform and advocate for our patients, our employees, our community needs, and of course our business interests.

 Thank you,

Sergio Munoz, Sr.

THAA President

 P.S. If you are not the owner or administrator please forward this email and attachment to them.

GREAT MEETING with HHSC Commissioner

Event 04 SUMMARY:  Tuesday, September 20, 2011,

        HHSC Commissioner, Tom Suehs

Thanks to State Rep. Armando Martinez, Dist. 39 efforts, the Valley health care community got to spend some time with Texas Health and Human Services Commission (HHSC) Executive Officer, Mr. Tom Suehs

and his support staff.  The meeting was very informative and maintained an open question and answer dialogue through out the entire 90 minutes.  News Media were present also.

Over 100 attendees focused issues as follows:

      Patient/client enrollment process; cutoff dates

o      Contracting timelines with local health providers

o      Managed Care Organization (MCOs) accountability and

Responsibility and transparency

o      Service area Medicaid population size and health provider pool

o      Reimbursement fees and payment cycles

o      MCO readiness criteria

o      Bilingual materials and client needs assessments

o      MCO pre and post utilization benchmarks

o      Ensuring that client rights are not violated

o      Explanation of STAR and STAR+Plus program

o      Complaint and appeals process

o      Future training sessions

Most of the questions were answered and some were taken back for further review.    It will take many meetings like this one to inform the general public of changes coming over the next few months. 

Implementation is set for March 2012.

The biggest issue for a successful start is that it will take maximum coordination and cooperation between the State agencies, the MCOs, the health providers, in order to ensure a smooth transition of health services to Medicaid population.

Clic here for  Meeting Pictures

PLEASE VISIT OUR WEBSITE FOR UPDATES:  www.texashaa.org

State Rep Armando Martinez Invite

Our Association has been asked by State Rep. Armando Martinez, Dist 39, to communicate this Invitation to you regarding an important conference, this Tuesday Sep. 20th.
=====================================================================

Special Invitation from State Rep. Armando Martinez, Dist. 39 to an Informative Conference          Background:   The 82nd Legislative Regular and Special Sessions sent over 1500 Bills to the    Governor.   SB7 and HB7, also known as the healthcare bills, included several changes in health care, including the mandated expansion of managed care organizations (MCOs) to provide health care to the 10-county Hidalgo Service Area.  These Counties included: Hidalgo, Cameron, Willacy, Duval, Jim Hogg, Maverick, Webb, McMullen, Starr and Zapata.  The MCO system implementation date is March 1, 2012.                    Conference Purpose:  To inform affected primary care providers, other health care providers, local government agencies, city and county officials, and the general public of healthcare changes coming to the Valley including the new MCO health care system.  Coordination of services among health agencies, both public and private is needed to ensure that the general public in particular the Medicaid population is transitioned into this new system with no interruption in health services.  The 3 MCOs for the Hidalgo Service Area will be invited and formally introduced. ==================================  Keynote Speaker: The Honorable, Armando Martinez, House of Representatives,  District 39

CORDIALLY INVITES YOU

TO A SPECIAL MEETING WITH

COMMISSIONER

 of the Texas Health and Human Services Commission,

(hhsc)

FOR A BRIEF OVERVIEW ON HEALTH ISSUES

IMPACTING THE VALLEY.

================================================ Special Keynote Speaker HHSC Commissioner, Tom Suehs

===============================================

SPECIAL Invited Guests; Various State and Local Elected Officials

 ===============================================

When:  Tuesday, September 20th, 2011 at 11:30-1:00pm Where:  All Valley Medical Service 3406 W. Alberta, Edinburg, Tx Map at our website.

PLEASE REGISTER AT WEBSITE;   www.texashaa.org         Event Subject to Change...     Seating is limited; one representative per agency.

STATE “APPROVES” A TRIAL PERIOD!!!

RE:  STATE “APPROVES”  A TRIAL PERIOD!!!

On September 2, 2011, representatives of the Texas Healthcare Advocacy Association (THAA) met with House HHSC Committee Chairman Richard Pena Raymond (Dist 42), St. Rep. Sergio Munoz, Jr. (Dist 36) and HHSC Commissioner Tom Suehs and his Staff (Paula Swenson and Joe Vaigattie) to present our official request for a PRE Trial/Pilot Component.

After listening to our request and reviewing our documentation of over 100 letters of support servicing over 17,000 clients HHSC Commissioner Mr. Suehs, instructed his staff to proceed and find a method of providing a “test drive” before March 1^st, 2012. Chairman Raymond was also in agreement with Commissioner Suehs for some form of a simulation period. Barring any unforeseen circumstances, policies, or other legal issues our request for a trial phase has been tentatively APPROVED, with some adjustments.    

This is GREAT NEWS!!!
 
One of the biggest issues that surfaced was the federal HIPAA 90 day requirements; leading to some adjustments of our request. Essentially, clients/patients must be afforded a minimum of 90 day to select their MCO! According to the State this HIPAA cut off date is February 14^th, 2012. Because of this requirement the State can only provide “mock or dummy” participant data to providers and MCOs for any simulation testing.

As mentioned earlier, barring any unforeseen circumstances, policies or other legal issues, the State has agreed to provide a handful of mock client files to providers and MCOs to do “simulation” data entering/editing and billing/s prior to March 1^st, 2012. According to State officials this type of trial has never been proposed or done before. However, they believe it may lead to a smoother transition and will begin planning the specifics of our proposed trial phase. MCOs must also agree to this simulation. This mock trial period will only be done for LTCSS providers ie, DAHS, PHC, DME, etc

 What does this mean to you? Well in effect you will get to simulate billing/claims and other data entry requirements with each MCO; granted for a handful only! However it provides some measurement that the MCO and Providers (you) are capable and ready ie..billing. It should provide you with errors report and provide you with how many were “clean claims” ; something that is critical for everyone prior to March 1^st, 2012.

 So once again, your cooperation and hard work has gone a long way!!! Now all we have to do is make sure we attend all MCO trainings and wait for this “trial” phase. It will probably be in late January 2012 ; we will keep you posted on this.

 Please check our website for more information and pictures; www.texashaa.org

check regularly for updates on this matter.

We thank all of those who provided letters of support; we believe these documents and data made a significant impact on the HHSC Commissioner and Chairman Raymond.

I would also like to thank Mr. Jesus Navarro of Cielito Lindo Adult Day Care and Mr. Jon Scepanski of Apex Primary Care who made the time to make this meeting.

 It takes TEAMWORK!!!

Thank you all. GREAT TEAMWORK!!!

 Sergio Munoz, Sr.

THAA President

We meet with Charman Raymond and HHSC Commissioner

On Friday , Sep 2nd  our Association is officially meeting with House HHSC Committee Chair Richard Pena Raymond, Dist 42 and HHSC Commissioner Tom Suehs and his staff.  Purpose: to present our official request for a 30 day Pre Trial/Pilot Component prior to March 1, 2012. 

The 10 county Hidalgo Service Area will come live on March 1st, 2012 in the expansion of the Star+Plus Program.  With it comes a transition of services to a managed care organization (MCO) health care system.  This "rollout" is the largest in the State.  Several thousand local healthcare providers and ten of thousands of elegible medicaid population groups will be impacted by this rollout.

The Texas Healthcare Advocacy Association will provide some proposed changes to the timelines and thus provide for a more efficient, smooth, and cost-savings implementaion.
We will keep you updated on our request at our website;  www.texashaa.org

Thanks to over 100 agencies who provided a letter of support.  Collectively these agencies provide healthcare services to over 17,100 patients/clients in the Hidalgo Service Area.