The goal of the Administrative Simplification Task Force is to reduce cost and administrative complexity by streamlining health administration processes for providers, payers and government.
The Administrative Simplification Task Force first identified key external partners - including payers, providers, business interests, and others - to develop suggestions for the Commonwealth with the goal of streamlining health administration processes. Reviewing recommendations offered by 14 entities, the Task Force conducted initial analyses of the suggestions and solicited comments from multiple state agencies. The Task Force then met with survey responders to solicit additional details about their suggestions.
The key issues include provider credentialing and process efficiency; duplicative data reporting requirements to the state; and the licensure process for HMOs.
The Taskforce has begun to make progress in these areas:
- Provider credentialing and efficiency of the Health Care Administration Simplification (HCAS) process
- The Task Force researched the issues presented by the survey responders, as well as the history of credentialing in Massachusetts. The Task Force also drafted a memo on its credentialing issues findings, and a letter to Lori Burgiel, Executive Director of HCAS, which was sent by Secretary Bigby, summarizing initial findings and proposing a meeting of HCAS and the Task Force.
- Duplicative data reporting to the state
- A major component of duplicative data reporting is the submission of claims data to multiple state agencies, in different formats and varying frequency. The Task Force has assigned an analyst to perform an initial review of this issue, which will allow a workgroup of the relevant agencies to identify appropriate remedial actions.
- Licensure Process for HMOs
- Currently, the HMO licensure process is done on an annual basis and has proven unnecessarily costly for both the health plans and state regulators. House Bill 971 would change HMO licensure to every other year. The Task Force has analyzed this change and supports the bill.
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