October 8, 2019

The OIG closed its inaugural managed care transition plan for fiscal year 2019. The OIG has improved its approach, infrastructure, expertise and collaboration in the agency’s work in managed care. The managed care transition plan included details about:

• Recoveries: The plan mapped existing OIG processes in all areas related to recoveries and provided recommendations to improve the integrity of OIG recovery efforts including better system-wide approaches, maximizing organizational efficiencies and improving reporting on recoveries.

• Transition of Utilization Reviews: The OIG quantified the impact of Nursing Facility Utilization Review’s work in managed care by reporting the amount of dollars MCOs adjusted in encounters since initiating reviews.

• Managed Care Professional Development: The OIG provided many opportunities for staff to learn more about managed care including Explore OIG sessions, regional trainings, and new online reference materials.

In fiscal year 2020, one of the OIG’s priorities will be to create a forum for all areas to share ideas and develop solutions for key projects in managed care. You can read more about the OIG’s work in managed care in our latest quarterly report: https://tinyurl.com/TxOIGQRs