Passport Plans Workshops for Members of Provider Network to Learn About New Claims System and Provider Portal

Passport is holding annual provider workshops to educate providers on Medicaid processes, procedures, and more. This year, Passport’s workshops will be dedicated to training on the new claims system and provider portal.

Passport will offer training opportunities around the state of Kentucky:

  • Bowling Green – Tuesday, August 29, at the National Corvette Museum, 350 Corvette Dr.
  • Pikeville – Thursday, August 31, at the Hilton Garden Inn Pikeville, 849 Hambley Blvd.
  • Erlanger – Wednesday, September 6, at Receptions, 1379 Donaldson Hwy.
  • Paducah – Friday, September 8, at Baptist Paducah Church, 2501 KY Ave.
  • Ashland – Tuesday, September 12, at the Ashland Plaza Hotel, 1441 Winchester Ave.
  • Owensboro – Thursday, September 14, at Moonlite Bar-B-Q Inn, 2840 W Parrish Ave.
  • Lexington – Tuesday, September 19, or Wednesday, September 20, at Fasig-Tipton Company, 2400 Newtown Pike
  • Louisville – Friday, September 22 or Monday, September 25 at Norton Women’s and Children’s Hospital, Plaza 1, 4001 Dutchmans LN, St Matthews, KY 40207 or Wednesday, September 27 at Home of the Innocents 1100 Market Street, Louisville, KY 40206

All training workshops will be held from 10 a.m. to 1 p.m. Eastern Time and will include lunch.

If a provider is unable to attend any of these dates, training webinars will also be offered on Tuesday, September 19, and Tuesday September 26, both at 2 p.m. Eastern Time.

To register, providers should email their date/location to providerinquiries@passporthealthplan.com, or can go to the “Educational Resources” section of Passport’s website then click on Provider Workshops. For providers who have questions, they can call Passport Provider Services at (800) 578-0775.

 

Passport Health Plan partners with The Little Clinic to increase healthcare access for members around Kentucky

little clinic logoPassport Health Plan has added The Little Clinic inside select Kroger stores around Kentucky to its growing network of accepted healthcare providers, effective January 1, 2017.

“We are very excited to add The Little Clinic to our network of healthcare providers around the Commonwealth,” said Mark B. Carter, CEO of Passport Health Plan. “Opening access to these additional services will allow our members to get the care and treatment that they need to live healthier lives.”

The Little Clinic locations are staffed with board-certified nurse practitioners authorized to diagnose, treat, and write prescriptions for many common illnesses such as bronchitis, sinus infections, seasonal allergies and the flu. The clinics also provide a wide selection of additional wellness services such as physicals, health screenings, tobacco cessation, and a number of vaccinations.

The Little Clinic provides care for the entire family from age 24 months and up, seven days a week, including evenings. Appointments at The Little Clinic are not necessary and patients will experience little or no waiting time before being seen.

For more information, click here.

 

Passport aims to improve behavioral health among Kentucky’s Medicaid population

Passport logoApproximately 147,000 adults in Kentucky live with severe mental illness, many of whom are Medicaid beneficiaries. That’s why Passport is taking steps to ensure that some of the state’s most vulnerable residents have access to behavioral health services while reducing the financial cost for taxpayers.

“Behavioral health – which includes mental health and substance use disorders – is just as important as physical health,” said Elizabeth W. McKune, Ed.D., Passport’s Director of Behavioral Health. “Poor behavioral health is often the result of poor physical health, and vice versa. Medicaid patients across Kentucky must have access to quality behavioral health care in order to improve overall health outcomes and control health care costs.”

Passport’s statewide provider network includes more than 2,100 behavioral health specialists (as of June 13, 2016) who are committed to delivering timely, high-quality, clinically appropriate behavioral health services to Medicaid patients. Behavioral health providers have access to online and in-person resources and training seminars to help improve the delivery of care.

Passport also offers a behavioral health hotline, available 24 hours a day and 7 days a week, to assist members in crisis and emergency situations, help them find local behavioral health providers, and get them connected to additional services or resources they may need. Other behavioral health services available for Passport’s members include medication management, substance use disorder treatment, outpatient services such as counseling, and even inpatient treatment when providers and patients feel that outpatient treatment is insufficient.

“From providers and insurers to patients and nonprofits, many in the Commonwealth have a vested interest in improving health, including behavioral health,” said Dr. McKune. “This is a statewide effort that requires all hands on deck.”

To read more, please click here.

 

Passport creates new specialty pharmacy network to better manage certain prescription drugs

Passport logoPassport Health Plan is pleased to announce that we are establishing a new network to better manage specialty prescription drug products. Specialty medicines are defined as prescription medicines used to treat complex, chronic illnesses, including multiple sclerosis, rheumatoid arthritis, hepatitis C, hemophilia, and more.

Through this specialty pharmacy network – which will be established and managed by MagellanRx Management – Passport members will receive convenient access to specialty services such as:

  • Comprehensive coordination of care, including prior authorization coordination and ongoing refill reminders
  • Direct access to pharmacists and/or nurses available to answer any questions
  • Clinical programs to monitor their progress to achieve optimal outcomes
  • Educational materials, such as instructional guides to assist with self-administering medications
  • Free delivery of medication
  • Ancillary supplies such as syringes and needles, if needed, at no additional cost

All providers in Passport’s networks have been notified that effective November 17, all prescription drug requests for specialty products for Passport members should be submitted to a specialty network pharmacy for fulfillment. For providers who need to find a specialty pharmacy within the network or to find a list of specialty products included in this benefit, they should simply call MagellanRx Provider Operations at 1-800-441-6001.

If you have any questions about this update, providers are encouraged to contact their provider relations specialist or call Provider Services at 1-800-578-0775. For all other questions, please call 1-800-578-0603.

 

Passport Plans 9 Workshops Around Kentucky to Help Educate Providers

Passport logoPassport Health Plan is planning 9 provider workshops all across the Commonwealth to teach providers about topics such as new benefits, ICD-10, provider resources and more.

The Provider Workshops will run from 9 a.m. to 1 p.m. (local time) and include a catered lunch. The workshops will be:​

  • Wednesday, October 7: Tom Sawyer State Park-Sawyer Hayes Center, 2201 Lakeland Road, Louisville, KY 40241
  • Thursday, October 8: Rough River Dam State Park Lodge, 450 Lodge Road, Falls of Rough, KY 40119
  • Wednesday, October 14: Bowling Green Chamber of Commerce, 710 College St., Bowling Green, KY 42101
  • Thursday, October 15: Lake Cumberland State Park Activities Center, 5465 State Park Road, Jamestown, KY 42629
  • Wednesday, October 21: Jenny Wiley State Park-Wilkinson/Stumbo Conference Center, 75 Theater Drive, Prestonsburg, KY 41653
  • Thursday, October 22: Blue Licks Battlefield State Resort Park, 10299 Maysville Road, Carlisle, KY 40311
  • Wednesday, October 28: Lake Barkley State Park Convention Center, 3500 State Park Road, Cadiz, KY 42211
  • Thursday, October 29: Moonlite BBQ, 2840 West Parrish Avenue, Owensboro, KY 42301
  • Wednesday, November 4: Kentucky Horse Park, 4089 Iron Works Pike, Lexington, KY 40511

Attendance is free, but all providers need to RSVP to register with Carol Meadows by calling (502) 585-7962 or sending an email to Carol.Meadows@passporthealthplan.com. For more information, please click here.

 

Medical Nutrition Therapy Services are Covered Under the Passport network

Passport logoFor providers who are in the Passport Health Plan network who may have added Medical Nutrition Therapy (MNT) services, or for those providers who may be new to Passport, this serves as a reminder that MNT is covered as long as the services are provided by a registered dietician or certified nutritionist and the services were provided under supervision of a PCP or other physician.

A licensed nutritionist or dietician will be covered for services if:

  • The individual is employed by (not referred) the supervising physician;
  • The individual is licensed in the state of practice; and
  • The supervising physician has direct physician contact with the recipient.

No Prior Authorization is required.

For any provider who has questions about MNT, you can contact Provider Services, (800) 578-0775 or your provider relations specialist. To see other “eNews” mailings that get shared with providers, please click here.

 

Passport Unveils New ‘Searchable Drug Formulary Tool’ for Providers

logoPassport Health Plan’s new online “Searchable Drug Formulary Tool” has been developed to assist providers with identifying preferred drugs on Passport’s formulary.

The tool allows all of our providers to search the formulary status of prescription drugs (Preferred vs. Non-preferred) by Therapeutic Class or Drug Name (Brand or Generic), as well as an option to find alternate therapies.

For qualifying drugs, the tool will also display special considerations, including:

  • Quantity limits
  • Prior Authorization requirement
  • Step Therapy requirement
  • Specialty drug status
  • Age or gender limitations

The Searchable Drug Formulary Tool is available to Passport providers by clicking here. For more information, please contact the Magellan Pharmacy Helpdesk at 1-800-846-7971.

 

Passport Helps Child Members Continue to Receive Medically Necessary Services Through Summer

logoPassport Health Plan has sent out a communication to all of the providers in our network to assist them in ensuring that school-age children continue to receive medically necessary services during summer break. Many children that receive school-based services during the school year may continue to receive medically necessary services during school breaks when ordered by their primary care physician (PCP) and pre-authorized, if required.

It is important for PCPs to determine if child members receive school-based services through an Individualized Education Program (IEP) or an Individualized Family Service Plan (IFSP) through First Steps. These services may include Speech/Language, Occupational and Physical therapies or other services that will help enhance the child’s development or aid in allowing the child to reach academic goals in their schoolwork. Parents may not be aware that medically necessary services are available during school breaks through their child’s Passport Health Plan benefits. Services directly related to academic goals are provided by school systems.

If you have any questions regarding these requirements, please call Passport’s health school board manager at (502) 213-8955 or, if you are a Passport provider, contact your provider relations specialist. To see other Passport eNews communications to providers, click here.

 

Passport Participating in ‘Zero Suicide’ Initiative to Help Train Providers and Advocates

suicideOver the years, there have been all kinds of initiatives to make roads safer – such as seatbelts, speed limits, and air bags, to name a few. We even have electronic signs now over interstates and next to roadways to alert drivers to dangers. However, did you know that since 2008, more people have died in Kentucky each year by suicide than from automobile accidents?

Our society recognized that the number of individuals killed in automobiles was unacceptable and took steps to reduce that number dramatically. Now, a new movement has taken hold to address another public safety issue in a dramatic way. Suicide is a public health issue that has been growing way too fast. We at Passport wanted to pass along information about the “Zero Suicide” initiative, which has a bold goal for both physical and behavioral health care providers to reduce the number of deaths by suicide to zero.

In 2013, Kentucky passed a law requiring mandatory training requirements for social workers, marriage and family therapists, professional counselors, fee-based pastoral counselors, alcohol and drug counselors, psychologists, and occupational therapists in suicide assessment, treatment, and management. But suicide prevention is not just the job of behavioral health providers. More than half of people who died by suicide saw their general practitioner in the month before their death, and more than 10% were seen in an emergency department within the 60 days before their death.

The goal of this initiative is to make suicide an event that an individual and their friends and family NEVER have to experience again.

To learn more about how healthcare providers and advocates can take part in making this goal reality, go online to zerosuicide.sprc.org.

To read a pamphlet of important information that you can use if your teen is thinking of suicide, please click here.

 

CMS Says it will Subject Some Medicaid Providers to Criminal Background Checks to Prevent Fraud

cmsAccording to a letter sent Tuesday to state Medicaid directors by the U.S. Center for Medicare & Medicaid Services (CMS), all healthcare providers who are considered “high risk” for defrauding state Medicaid programs will have to undergo a criminal background check starting August 1.

States will need to “use their discretion to rank providers,” wrote Virgil Dickson in an article in Modern Healthcare about this announcement, adding that “all of a states’ Medicaid and CHIP providers must be ranked as having a limited, moderate or high risk of defrauding the program” by March 2016.

“Strengthening and improving upon programs that provide vital services like Medicaid to millions of Americans is a continuous process, and at CMS we take seriously our responsibilities to taxpayers and beneficiaries,” said Dr. Shantanu Agrawal, director of CMS’ Center for Program Integrity, said in the Modern Healthcare article.