2018 State HIT Connect Summit has ended
Friday, April 6 • 8:00am - 8:46am
States of Implementation Roundtable 12: Medicaid Provider Enrollment and Screening Meets Credentialing – Where States are Headed

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The Affordable Care Act (ACA) substantially changed the requirements for screening and enrollment of Medicaid providers. Providers must be placed into categories of risk; Limited, Moderate, and High. There are new requirements for periodic background and sanction checks, facility site visits, fees, and many other tasks. Another complicating factor is the role of Medicaid Managed Care Organizations (MCOs) in this process. While MCOs typically have responsibility for provider credentialing, it is often separate from screening & enrollment, creating redundancy and confusion for stakeholders. A number of States have begun to combine the Credentialing process with Medicaid Screening & Enrollment. This roundtable will explore what states are doing and the implications for Medicaid Programs, MCOs, and Providers.

avatar for John P. Crouse

John P. Crouse

Vice President, MAXIMUS Health Services
John Crouse is Vice President of Health Services for MAXIMUS. John has over 30 years of experience in International, Federal, and State health and human services programs. His experience includes Medicaid systems and operations, Pharmacy Benefits Management, member and provider customer... Read More →
avatar for Billy Millwee

Billy Millwee

President/CEO, BM&A Public Policy
Billy is the President/CEO and Founder of BM&A Public Policy. Until August 2012 he served as the Texas Health and Human Services Deputy Executive Commissioner and Texas Medicaid Director. In this role he provided operational and programmatic leadership for the Texas Medicaid and CHIP... Read More →

Friday April 6, 2018 8:00am - 8:46am PDT
Key Ballroom 7-8 & Foyer