Education event

Mastering Medi-Cal Managed Care Webinar
Medi-Cal Managed Care 101, Contracting and Accountability

 

Registration is now closed.
Please call the Education Department at (916) 552-7637.

January 30, 2018
10:00 a.m. – 12:00 p.m., Pacific Time

Overview

Over the past two years, the Medi-Cal program has grown significantly and now serves approximately one-third of Californians, with nearly 80 percent enrollment in managed care.

The rapid expansion of Medi-Cal has meant a large transition for particularly vulnerable populations, including seniors and persons with disabilities, as well as low-income families. This shift has also affected hospitals as they attempt to coordinate benefits and ensure Medi-Cal patients are receiving the right care, at the right place, and the right time and that Medi-Cal managed care plans are meeting their obligations in managing care for millions of Californians.

Plan to participate in this webinar and gain a clear understanding of Medi-Cal managed care.

Recommended for:

Chief operating officers, chief financial officers, clinical operations executives, case management directors, legal counsel and finance staff.

Agenda

Background on Medi-Cal managed care

  • Who’s responsible, governing authorities
  • Types of Medi-Cal managed care, how they’re different
  • Top misconceptions about Medi-Cal managed care
  • Update on recent network adequacy requirements

Top tips for contracting and working with Medi-Cal managed care plans

  • Documentation, documentation, documentation!
  • Negotiating medical necessity, eligibility, authorization
  • When plans make unilateral amendments to the contract
  • Managing the dispute process — steps to resolution
  • Addressing a plan’s refusal to contract

Ensuring coverage and payment for out-of-network services

Steps to hold health plans accountable for patient placement and payment

Recommendations for working with county mental health plans

Faculty

Felicia Sze recently founded the law firm of Rotenberg & Sze, with offices in Sacramento and San Francisco.  Previously, she was a partner for three years at Hooper, Lundy & Bookman.  Ms. Sze is a recognized expert in Medicaid and Medicare reimbursement matters, focusing on both the managed care and fee-for-service programs.  She advises hospitals on these ever-changing programs with an eye to compliance and represents hospitals in disputes against managed care entities and government payors.

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CEs

Full participation in the webinar is required to receive professional continuing education (CE) credit. The registrant must complete an online evaluation, attest to participation and, when required, provide a professional license number.

Compliance — The Compliance Certification Board (CCB)® has approved this event for up to 2.4 CCB CEUs. Continuing Education Units are awarded based on individual attendance records. Granting of prior approval in no way constitutes endorsement by CCB of this event content or of the event sponsor.

Healthcare Executives — CHA is authorized to award 2.0 hours of pre-approved ACHE Qualified Education credit for this program toward advancement, or recertification, in the American College of Healthcare Executives. Participants in this program who wish to have the continuing education hours applied toward ACHE Qualified Education credit must self-report their participation. To self-report, participants must log into their MyACHE account and select ACHE Qualified Education Credit.

Legal — CHA is a State Bar of California-approved MCLE provider. This participatory activity has been approved for 2.0 hours of MCLE credit. Provider number 1980.

Important note: While more than one individual from your organization may listen to the webinars, CEs will only be awarded to the registrant.

Tuition

Members $185
Nonmembers $250
Multiple staff can participate from one location for one tuition fee.

Members are CHA member hospitals, CHA associate members and government agencies. Nonmembers are limited to non-hospital health care providers, clinics, post-acute facilities, and consultants, insurance companies, law firms and other entities that serve hospitals. Education programs and publications are a membership benefit and are not available to eligible nonmember California hospitals.

Cancellation Policy/Late Payment: A $50 nonrefundable processing fee will be retained for each cancellation. Cancellations must be made in writing seven or more business days prior to the scheduled session and emailed to education@calhospital.org. No refunds will be made after these dates. Substitutions are encouraged. Please note that payment is due on or before the program. Payments not received by the program date may be subject to a 10% late fee. In the unlikely event the program is cancelled, CHA will fully refund paid participants within 30 days.

Special Accommodations or Questions: If you require special accommodations pursuant to the Americans with Disabilities Act, or have other questions, please call (916) 552-7637.

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