NJAMHAA FY2022 Annual Report

23 • Catholic Charities, Diocese of Trenton • Center for Family Services • Community Hope, Inc. • Easterseals NJ • Family Connections • Family Guidance Center of Warren County • Hackensack Meridian Health - Jersey Shore Uni - versity Medical Center • Hendricks House Group, Inc. • High Focus Centers Pyramid Healthcare Hammonton • Inroads to Opportunities • Jewish Vocational Services • Mental Health Center of Passaic • Oaks Integrated Care • Pineland Regional School Based Youth Services Program • Rescue Mission of Trenton • SERV Behavioral Health System, Inc. • South Jersey Behavioral Health Resources, Inc. • St. Joseph’s Regional Medical Center • Total Family Solutions • Vantage Health System • Volunteers of America - Greater New York The Integrated Healthcare Council (IHC) was originally established in 1996 as the Managed Health Care Council to address concerns about behavioral health care being carved into managed care. Since behavioral health services were not carved in at that time, the group was transitioned into the Integrated Healthcare Council, which also includes businesses that offer a variety of products and services (e.g., furniture, insurance, diagnostic testing), as well as the health maintenance organizations (HMOs). The IHC members are: • Acutis Diagnostics • Aetna Better Health of New Jersey • Amerigroup Corporation • AmeriHealth New Jersey • Ammon Labs • Attitudes In Reverse® • Community Access Unlimited • Dennis C. Miller Associates • Gallagher Benefit Services • Genoa Healthcare • GoMo Health® • Horizon NJ Health • Mercadien Group • Mutual of America Financial Group • Optum Health/UnitedHealthcare • PerformCare New Jersey • Rutgers School of Social Work • Society for the Prevention of Teen Suicide • TrueTox • WellCare Health Plans NJAMHAA created the Health Maintenance Organization (HMO) Council in 2011 to establish collaborative relationships between the HMOs and provider organizations. The goals are to build understanding of each HMO’s and provider’s mission and services, and to jointly ensure that all Medicaid beneficiaries have equal access to the most appropriate and highest quality integrated care. This group is chaired by Sam Currie, RPh, Director of Pharmacy Services, Horizon NJ Health. Representatives from the HMOs participate on the HMO Council along with providers and staff from the Division of Mental Health and Addiction Services (DMHAS) and Division of Medical Assistance and Health Services (Medicaid) to address challenges, particularly in serving the Medicaid population — most notably, the upcoming transition of all mental healthcare and substance use services to Medicaid Managed Care under the 1115 Waiver. This group hosted extremely informative panel discussions on managed care in general and a more detailed presentation on prior authorizations, utilization management and Healthcare Effectiveness Data and Information Set (HEDIS) outcome measures. Among several topics for upcoming discussion is credentialing of treatment facilities and individual providers, as part of enrolling into the HMOs’ networks. The council addresses commercial managed care issues, as well. Ward Sanders, Esq., President, New Jersey Associa - tion of Health Plans, moderated the panel discussions on managed care, which featured the HMOs’ behav - ioral healthcare directors. He also shared his insights into enrollment and many other Medicaid-related issues throughout the year.