Medicaid Programs and Compliance - Random thoughts

Medicaid Programs and Compliance - Random thoughts

I've had a few things come across my lap in the past months and read a few articles on some trends.  With the ACA I think it is safe to assume that these populations will grow substantially, this does not mean your job will get any easier. These populations are notorious for medical non-compliance for a variety of reasons(apathy, economic, education, age, disability).  Organizations will find that traditional methods will not work with them as proven over the last 20+ years.  Organizations will try to tap new methods of outreach to get these members to improve their health.  I think you will see a host of new services that have been offered to the commercial populations being offered to medicaid as a way to incentive the members.  This does come with some danger as these programs could be potentially abused and defrauded.  Another area that will constant dangers is communications with the member. Mail just doesn't reach folks the way it used to.  That leaves electronic forms, text, phone and email.   All areas that are potential HIPAA concerns.  Cell numbers and text address changes constantly as plans are dropped and phones retired.  There will be a need for better phone look-up and verification.  I can see bottom feeding lawyers targeting Health Plans over HIPAA with this.  Email has it own problems unless it a free universal provider like Google and Yahoo as people change email fairly regularly. But remember email is that "secure" either. I hope the compliance officer gets cracking on that computer science degree...