Newsroom > DHHS News Release
For Immediate Release
April 15, 2016
Contact Kathie Osterman, Communications and Legislative Services, (402) 471-9313 or email@example.com
DHHS Announces Contracts Signed for Heritage Health
United, Nebraska Total Care, and Wellcare to Operate Integrated Medicaid Health Program
Lincoln, NE— The Department of Health and Human Services’ Division of Medicaid and Long-Term Care (MLTC) announced today that contracts have been signed for the new integrated Medicaid managed care program, Heritage Health, that will transform Nebraska’s current physical health, behavioral health, and pharmacy programs into a single comprehensive and coordinated delivery system for Nebraska’s Medicaid and Children’s Health Insurance Program (CHIP) enrollees. The three health plans selected will operate statewide beginning January 1, 2017.
“The integrated services provided through Heritage Health will result in better health outcomes, improved customer service, and a reduced rate of costly and avoidable care for Medicaid enrollees, some of whom are among our state’s most vulnerable citizens,” said Courtney Phillips, DHHS CEO. “Heritage Health will also bring streamlined processes and efficiencies to state government resulting in greater value to Nebraska taxpayers.”
The three contracted Heritage Health plans are:
• Nebraska Total Care (Centene)
• UnitedHealthcare Community Plan
• Wellcare of Nebraska
UnitedHealthcare Community Plan has a current contract with Nebraska Medicaid, while Nebraska Total Care and Wellcare of Nebraska will be entering the Nebraska market.
“We look forward to working with these three health plans as we prepare to launch Heritage Health,” said Calder Lynch, DHHS Medicaid Director. “The state is committed to providing a smooth transition for our clients and providers.”
Currently, Nebraska contracts with three health plans, one for physical health services like doctor visits and hospital care, one for behavioral health services, and another to manage pharmacy services on behalf of the state. Under Heritage Health, Medicaid and CHIP enrollees will choose one health plan that will be responsible for this full array of services.
There are approximately 230,000 Medicaid and CHIP enrollees who will be served by Heritage Health plans, including approximately 41,000 enrollees who have been previously excluded from the physical health managed care program and will now receive the benefits of coordinated care for their physical, behavioral, and pharmacy services.
All recipients will be given the opportunity to choose the health plan that best meets their needs during an open enrollment period scheduled to start this fall, and all members will retain the option to change health plans for ninety (90) days after enrollment. The Department is also contracting with an enrollment broker that will assist clients with choosing their Heritage Health plan. On March 31, the Department of Administrative Services announced the intent to award this contract to Automated Health Systems (AHS), pending final contact negotiation.
Prior to the implementation of Heritage Health on January 1, 2017, several steps remain. Each health plan must demonstrate it has a comprehensive network of primary care providers, specialists, hospitals, pharmacies, behavioral health professionals, and other provider types in place to treat patients; sufficient support staff to handle administrative processes and provider relations; and the ability to meet all the deliverables specified in its proposals. The health plans will undergo a thorough readiness review before their network can begin providing services to Medicaid recipients. Nebraska Medicaid will also be forming several advisory groups to assist in the transition of new services and populations to managed care. The Centers for Medicare and Medicaid Services (CMS), the federal agency that monitors states’ Medicaid programs, will review each health plan’s network adequacy and will review and approve the contracts.
For more information on Heritage Health, including procurement materials, a fact sheet, and frequently asked questions, please visit http://dhhs.ne.gov/HeritageHealth