Medicaid managed care. SB 1150 es- tablished a multistakeholder work- group of physicians, health plans, and others who put the credentialing re- pository on their wish list. Former Texas Medicaid director and health care consultant Billy Mill- wee heads up the project, initiated by the Texas Association of Health Plans (TAHP). He says the organiza- tion shares physicians’ desire to make Medicaid less administratively com- plex and sought a private market solu- tion to create a common credentialing platform. The Texas Hospital Asso- ciation (THA) has joined forces with TAHP to explore a similar option for hospital credentialing.
“I’m optimistic this is going to go a
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long way to really reduce the hassle providers face in Medicaid, given the creative thought put into a private sec- tor response,” Mr. Millwee said. TAHP and THA are still research- ing and developing the platform but look to Arizona for precedent. That state mandates that all Medicaid man- aged care plans participate in a cen- tralized credentialing hub “because they felt so strongly about simplifica- tion,” Mr. Millwee said. The Arizona Association of Health Plans Creden- tialing Alliance launched in late 2013. Georgia is following suit. In Texas, as part of the sunset re-
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view process — which the legislature uses to regularly evaluate the perfor- mance of state agencies — an exten- sive bill to overhaul HHSC, Senate Bill 200, requires the agency to streamline Medicaid enrollment and creden- tialing processes by Sept. 1, 2016. SB 200 specifically authorizes HHSC to designate a centralized credentialing entity and require Medicaid HMOs to use it. Gov. Greg Abbott signed that bill into law on June 17. Mr. Millwee anticipates the proj- ect will be up and running within the legislature’s prescribed time frame. While the first rollout would encom- pass Medicaid plans, it could ulti- mately expand to include commercial insurers, as well.
58 TEXAS MEDICINE August 2015
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