ACAP names Monroe Plan a Preferred Vendor

Monroe Plan for Medical Care is pleased to announce that we have been recognized as a Preferred Vendor by the Association for Community Affiliated Plans (ACAP). ACAP is a national trade association which represents not-for-profit SafetyNet Health Plans. Collectively, ACAP plans serve more than twenty million enrollees through Medicaid, Medicare, Marketplaces and other public health coverage programs. Monroe Plan’s ACAP Preferred Vendor status further substantiates our outstanding reputation and recognized expertise in the Managed Care sector.

September 2022 Provider Newsletter

MONROE PLAN INTRODUCES THRIVE AT HOME “GAP CLOSURE” PROGRAM
Tap into this no cost, value added clinical resource to reach difficult to engage Medicaid and HARP patients. Monroe Plan’s qualified team will schedule & complete preventative testing in the patient’s home.

We know that Medicaid and HARP patients often face significant obstacles to getting to the care they need such as limited transportation, childcare, and economic means. We also know that limited practice resources and time can impact quality of care. The in-home services provided through Thrive at Home can augment your team AND help patients overcome obstacles to accessing care. Most importantly, this program can serve as a gateway to reconnecting the patient with their primary and specialist caregivers!

Monroe Plan Introduces Thrive at Home “Gap Closure” Program

Monroe Plan Introduces Thrive at Home “Gap Closure” Program

Our Thrive at Home offers a no cost, additional clinical resource to our IPA providers.
Our Thrive at Home Outreach and Clinical Team will schedule and perform preventative testing and follow up right in the patients home which makes all the difference in reaching difficult-to-engage Medicaid and HARP patients.

We know that Medicaid and HARP patients often face significant obstacles to getting to the care they need such as limited transportation, childcare, and economic means. We also know that limited practice resources and time can impact quality of care. The in-home services provided through Thrive at Home can augment your team AND help patients overcome obstacles to accessing care. Most importantly, this program can serve as a gateway to reconnecting the patient with their primary and specialist caregivers! To learn more, please contact Samantha Tolbert, Clinical Quality Program Manager at thriveathome@monroeplan.com.

August 2022 Provider Newsletter

A MESSAGE FROM DR. GEORGE MATTHEWS, CMO
AUGUST IS NATIONAL IMMUNIZATION MONTH
“An Ounce of Prevention is Worth a Pound of Cure” Benjamin Franklin
Having experienced the COVID pandemic and acknowledging the impact of the COVID vaccines in preventing or mitigating the severity of illness, we may all appreciate the utility of vaccinations as a critical tool in maintaining good health. Vaccinations have traditionally been considered predominantly for birth to age 18. The conditions that we administer vaccinations for have previously been considered a scourge among the young resulting in death or significant impairment. Illnesses such as polio, diphtheria, tetanus, and whooping cough no longer provide concern in parents in whose babies have been vaccinated. Toddlers are now able to receive vaccinations for measles mumps, rubella, hepatitis, chickenpox (varicella) and flu. Again, it must be realized that these conditions provide for significant morbidity and mortality in the unvaccinated.

July 2022 Provider Newsletter

A MESSAGE FROM DR. GEORGE MATTHEWS, CMO
JULY IS NATIONAL MINORITY MENTAL HEALTH AWARENESS MONTH

Having endured the impact of the COVID-19 pandemic and more recently the hate filled racist attack in Buffalo New York it is not surprising that racial and ethnic minority communities face unique psychological challenges. Unfortunately, the opportunity to receive appropriate support for the mental health challenges is thwarted due to cultural stigma and the lack of access to mental health care services. Let us put the problem in perspective.

The Office of Minority Health from the US Department of Health and Human Services describes the following statistical assessment “In 2019 suicide was the second leading cause of death 4 blacks or African-Americans ages 15-24. Poverty level affects mental health status. African-Americans living below the poverty level as compared to those over twice the poverty level are twice as likely to report serious psychological distress”.

June 2022 Provider Newsletter

DR. MATTHEWS, MONROE PLAN’S CMO, INSIGHTS ON MEN’S HEALTH MONTH

As we think about our male patients, as well as those men that are most important to us (whether that is ourselves, our partner, father, son, or brother), we must reflect on how we can assist these individuals in maintaining a healthy lifestyle. According to the Centers of Disease Control, in the United States, men die an average of 5 years earlier than women. Men of color may experience even shorter lifespans. That being said, the leading causes of death in men aged 18 older are Heart Disease, Cancer, COVID-19, Accidents, and Stroke.

May 2022 Provider Newsletter

MONROE PLAN WELCOMES NEW CMO, DR. GEORGE E. MATTHEWS
We are excited to share that Dr. George E. Matthews has joined Monroe Plan for Medical Care as our new Chief Medical Officer. Along with a wealth of clinical and leadership experience, Dr. Matthews brings a career long commitment to community health naturally affiliating him with Monroe Plan’s mission to serve the underserved.
Dr. Matthews has practiced as a cardiologist in Western New York for the past 35 years. Building on a philosophy that the effective practice of medicine is an art as well as science, he has been driven to improve the quality of life for his patients by providing the highest quality of care.

April Provider Newsletter 2022

APRIL IS NATIONAL MINORITY HEALTH MONTH
The death rate for Blacks/African Americans is generally higher than whites for heart diseases, stroke, cancer, asthma, influenza and pneumonia, diabetes, HIV/AIDS, and homicide.

American Indians/Alaska Natives also have a high prevalence and risk factors for mental health and suicide, unintentional injuries, obesity, substance use, sudden infant death syndrome (SIDS), teenage pregnancy, diabetes, liver disease, and hepatitis.

Puerto Ricans have a low-birth-weight rate that is almost twice that of non-Hispanic whites. Also, Puerto Ricans suffer disproportionately from asthma, HIVAIDS and infant mortality. Mexican Americans suffer disproportionately from diabetes.

Ensure your practice engages in cultural competency training on an annual basis.
Cultural literacy leads to better engagement and connection to care providers.

Provider Newsletter – March 2022

MARCH IS COLON CANCER AWARENESS MONTH – 60% of Colon Cancer deaths could be prevented with screening.

Monroe Plan for Medical Care is proactively outreaching your patients who are turning age 50 in 2022 to educate them on colon cancer screening and, if applicable, ordering Cologuard tests. Please speak to your patients and let them know their options for screening. A FIT or gFOBT test is better than no test at all! The CDC offers a brief description of each test type to educate patients while encouraging them to consult with their physician about which test is best for them.

Provider Newsletter – February 2022

FEBRUARY is NATIONAL HEART MONTH

Heart disease is a leading cause of death for both men and women in the United States. Most middle-aged and young adults have one or more risk factors for heart disease, such as diabetes, high blood pressure, high cholesterol, or being a smoker or overweight. Having multiple risk factors increases the risk for heart disease.
• Ensure your patients know their blood pressure and are treated accordingly
• Ensure cholesterol is monitored
• Discuss lifestyle choices/barriers: diet, stress, smoking, access to medications
• Refer patients who need extra support to specialists; endocrinology, nutritionists, mental health support, NYS quit line.

To link patients to support, contact Monroe Plan’s case
management department at cmtriage@monroeplan.com or
speak to your MP Quality Representative. To learn more, visit:
https://www.nhlbi.nih.gov/education/american-heart-month.

Provider Newsletter – January 2022

THANK YOU FOR YOUR FEEDBACK: IPA SATISFACTION SURVEY RESULTS

Thank you to the 117 practices that participated in our IPA Satisfaction Survey. Of the practices that regularly use Monroe Plan services, approximately 90% indicated they are satisfied to highly satisfied. The survey indicates a high level of interest in Monroe Plan’s:
• Outreach to patients to help address gaps in care and other health disparities
• Coding Support and Education
• Contracting and Revenue Management Support (e.g., Provider-Plan contract reviews, Value-based Contract negotiation, Revenue cycle management)

Provider Newsletter – November 2021

FEEDBACK WANTED: IPA SATISFACTION SURVEY IN PROGRESS

On Monday, November 1 a brief satisfaction survey was sent via email to each practice. Please take a few moments to let us know how effectively we are supporting your practice, as well as what additional help your team needs. The email is from Monroe Plan for Medical Care . Your insights will help us tailor services that meet your needs. Thank you in advance for your feedback!

Provider Bulletins

If providers would like their patients to continue PCA/CDPAS services, updated MD orders must be faxed to Molina UM (866-879-4742) at least 30 days prior to authorization ending.  The form (DOH 4359) must be completed in FULL.  A missing CIN or DOB nullifies the form;  incomplete forms are considered unacceptable as per NYS DOH Regs.  Noncompliant orders will lead to your patient losing their aide services and it can take about 4-6 weeks for services to restart. Please review the forms for completeness before faxing to Molina.

 

Did you know that every Molina member receiving these services has an assigned RN Case Manager who speaks to the member every month? Please contact the Monroe Plan triage line at 844-337-7144 to get connected to the assigned Case Manager. S/he can assist you by providing support in submitting the 4359, answering questions regarding the LTSS process or address any concerns about your patient receiving these services.

 

To access the Physician Order Form, click here: Physician’s Order for Personal Care/Consumer Directed Personal Assistance Services (ny.gov)

 

Respectfully,

 

Monroe Plan for Medical Care Provider Network

Effective November 1, 2021, Molina Healthcare of NY (“Molina”) will be using a new vendor to manage its vision benefit for members enrolled in its Medicaid Managed Care, Essential Plan, HARP, and Child Health Plus products. The name of the new vendor is Superior Vision.

Click here to download: Superior Vision – Molina Provider Notice 11/2021

Please download the Coding crosswalk for claims submission for guidance

Click here to download

Effective for dates of service on or after October 15, 2020 note the coding changes required for claims processing as it
relates to PT, OT and ST services rendered to Molina Health Plan members.

Click here to download: PT, OT, ST Coding Changes Notice

This notice tells you about this upcoming change Please read this notice carefully and save it for future reference.

Click here to download: Pharmacy Carve Out Member Letter Notice

You can also access this notice at: health.ny.gov

Effective July 1, 2020, YourCare Health Plan’s Medicaid Managed Care, HARP, Essential Plan, and Child
Health Plus transitioned to Molina Healthcare of New York, Inc. Concurrently, Monroe Plan for Medical Care and affiliated entities entered into an agreement with Molina to provide network management and care management services.

Click here to download: Monroe Plan – Molina Fact Sheet

Monroe Plan Introduces Thrive at Home “Gap Closure” Program 

Our Thrive at Home offers a no cost, additional clinical resource to our IPA providers.

Our Thrive at Home Outreach and Clinical Team will schedule and perform preventative testing and follow up right in the patients home which makes all the difference in reaching difficult-to-engage Medicaid and HARP patients.  

We know that Medicaid and HARP patients often face significant obstacles to getting to the care they need such as limited transportation, childcare, and economic means.  We also know that limited practice resources and time can impact quality of care. The in-home services provided through Thrive at Home can augment your team AND help patients overcome obstacles to accessing care. Most importantly, this program can serve as a gateway to reconnecting the patient with their primary and specialist caregivers! Click here to learn more.

 

Network Compliance

Cultural Competency Training for Monroe Plan IPA Providers

Mainstream Medicaid Managed Care Providers are required to ensure the cultural competence of practice staff and to certify annual completion of New York State approved cultural competence training curriculum. The approved training, titled Think Cultural Health, offers several provider specific programs online, at no cost: https://thinkculturalhealth.hhs.gov/education. Providers and appropriate staff should complete this training in the next 12 months and annually thereafter. Once finished, please share your certificate of completion with us at providerrelations@monroeplan.com.
Be sure to review the bulletin and resource below to ensure cultural competency and compliance!

Click here to download: NYSDOH Cultural Competency Notice

Click here to download: Are You Culturally Competent?

To be sure your practice is accurately represented in Molina’s (MHNY) Provider Directories, you will want to regularly submit updated rosters to pfmemails@monroeplan.com.

Thank you for your cooperation!

Click here to download

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