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HealthCare Access Maryland. Central Region Connector Sheila Mackertich VP of Health Reform Initiatives. About HCAM. Non-profit agency created in 1997 Formerly Baltimore HealthCare Access Renamed to reflect expanded reach & focus Originally two core programs: Eligibility
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HealthCare Access Maryland Central Region Connector Sheila Mackertich VP of Health Reform Initiatives
About HCAM • Non-profit agency created in 1997 • Formerly Baltimore HealthCare Access • Renamed to reflect expanded reach & focus • Originally two core programs: • Eligibility • Care Coordination • Today: 19 programs/30 grants • Areas of expertise: • Eligibility & enrollment • Navigation of health care system • Care Coordination • Education & Advocacy • Diverse and culturally competent staff
HCAM -- Central Region Connector Central Region • Baltimore City • Baltimore County • Anne Arundel County • 17 Partners/ Subcontractors • Local Health Departments • Department of Social Services
Central Region Partners/SubContractors • Anne Arundel Medical Center • Baltimore City Health Department • Baltimore Healthy Start, Inc. • Baltimore Medical Systems • Charm City Clinic • Chase Brexton Health Services • Chatman, LLC • Coordinating Center • Healthcare for the Homeless • Independent Marylanders Achieving Growth Through Empowerment Inc. (IMAGE) • Maryland Medical Society (MedChi) • Mental Health Association of Maryland (MHAMD) • Mercy Hospital • Mosaic Community Services • Park Heights Community Health Alliance • Planned Parenthood of Maryland • St. Stephens African Methodist Church/ Office Management &Technology (OMT/SSAME)
Central Region Connector • HCAM and our 17 partners will employ 107 certified Navigators & trained Assisters to: • provide outreach and education • eligibility determinations • facilitate enrollment of the 217,000 uninsured central region residents into Medicaid, MCHP & subsidized/unsubsidized qualified health plans
Responsibilities • Navigators will: • Conduct public education and outreach as required by the Affordable Care Act • Distribute fair and impartial information • Facilitate enrollment in health plans • Provide referrals for grievances, complaints and questions • Provide information in a culturally and linguistically appropriate manner • Maintain expertise in eligibility, enrollment and program specifications • Refer insured small groups and individuals back to producers • Assisters will: • Conduct public education and outreach • Facilitate enrollment in Medicaid • Provide information in a culturally and linguistically appropriate manner • Maintain expertise in eligibility, enrollment and program specifications • Refer insured small groups and individuals back to producers • Both navigators and assisters will receive training through MHBE
Application Counselors • The Maryland Health Progress Act: • Application Counselor Sponsoring Entities: • MHBE may designate community-based organization, health care provider, unit of State or local government, or other entities as ACSEs. • Certified Application Counselors: MHBE may certify individuals as application counselors who: • Are employed by or volunteer with a sponsoring entity; • Are subject to the same requirements, restrictions, conflict of interest rules, and oversight applicable to navigators; • Are not compensated by the MHBE, carriers, producers, or TPAs for consumer assistance services; • Do not impose fees for consumer assistance services; • Must disclose conflicts-of-interest; and • Must act in the best interest of the consumer.
Application Counselors • Application Counselor Training & Certification Standards: • Certified Application Counselor may: • Provide information to consumers about the full range of QHP and QDP options and IAPs; • Assist consumers with the application process for determining eligibility for IAPs; • Facilitate plan selection and enrollment of eligible individuals in QHPs, QDPs, and access to APTCs; and • Provide to consumers uniform, factual, and unbiased information approved by the Maryland Medical Assistance Program about all participating MCOs and participating providers. • Certified Application Counselors may not: • Express a personal or professional assessment about, select or counsel an applicant about an MCO; or • Hold an Individual Exchange Navigator certification or be an Assister.
Central Region Connector Outreach/Education/Enrollment • Health Departments/Social Services • Faith-based organizations • Community based organizations: clinics, food banks, libraries, supermarkets • Civic Associations, clubs • Health fairs, festivals
Central Region Connector: Where We Are http://www.healthcareaccessmaryland.org/healthcare-reform/
Snapshot: First Two Weeks Statewide stats (10/1-10/17)* • Unique website visitors: 261,139 • Calls to call center: 25,149 • Accounts created with verified identity: 34,862 • Eligibility determinations completed: 23,141 • Enrollment into a plan: 2,393 * Source MHBE
Consumer Assistance • Online at www.MarylandHealthConnection.gov • Shop • Compare • Enroll • In-person Assistance • Navigators (Certified) • Assisters (Non-Certified) • Insurance Producers (Authorized) • Captive Producers • Application Counselors • Consolidated Services Call Center • 855-642-8572 • 855-642-8573 – TTY • Customer Service • Application and enrollment assistance • Language line/ translation services • TTY for the hearing impaired • HCAM Call Center • 877-223-5201
Sheila Mackertich Vice President of Health Reform Initiatives 410.649.0516 smackertich@hcamaryland.org www.healthcareaccessmaryland.org