Policy and Systems Committees
Billing Rules, Regulations and Policy Committee
This committee focuses on policies and issues associated with billing and collection for Medicaid reimbursement and some commercial insurance issues. The committee is comprised of corporate staff with broad experience in billing and collection policy and implementation issues. Members work together and with ABH to resolve billing challenges and to strive for better practices.
Meets monthly.
Corporate Compliance Committee
The Corporate Compliance Committee supports the work of members’ corporate compliance programs. It is staffed by external consultants who encourage the sharing of information and focuses on helping the MH and SA community-based providers comply with state and federal regulations. This includes assisting them with the development of internal operational oversight processes necessary to insure that compliance occurs.
Meets monthly.
Some specific areas of responsibility include:
- Integrating regulatory compliance into provider operations in an efficient and cost-effective manner
- Recordkeeping as required by regulation and in accordance with current and locally defined definitions of medical necessity
- DPH and other site visits for licensing/oversight
- Providing corporate counsel in investigations
- Staff misconduct
- OIG guidance on corporate compliance
- Training on how to ensure internal systems produce accurate billing, etc.
Managed Care Committee
The Managed Care Committee focuses on policies and issues related to the dominant managed care purchasers (MCOs, HMOs, carve-out companies) that contract with ABH members for both public sector and commercially insured populations. The committee addresses such issues as the Massachusetts Behavioral Health Partnership and MCO contracts, utilization management protocols of various payers, changing enrollment trends among the managed care organizations, various managed care initiatives and the impact of managed care on different components of the behavioral health system.
Meets on an ad hoc basis.
Human Resources Committee
This committee focuses on the human resources needs and interests of ABH’s members such as employee recruitment and retention, performance management and evaluations, documentation, communication, health insurance, staff orientation, and tuition reimbursement. The committee is currently in the process of developing a salary survey.
Meets monthly.
Quality and Outcomes Committee
This committee focuses on a variety of issues related to quality improvement and outcomes measurement, preferred practice guidelines, evidence-based practices, regulation, accreditation, utilization review/management, and general issues related to members’ efforts to measure treatment outcome.
Meets every other month.
Uniform Financial Reporting Committee
The Uniform Financial Reporting Committee initiates professional studies and reviews of member annual financial performance as recorded in uniform financial reports required of all contractors with the Commonwealth. The reports display ABH members compared to all UFR filers in a variety of financial benchmarks designed to assist managers.
Meets on an ad hoc basis.
Framing Committee
This committee develops strategies to improve the public perception of community-based programs providing mental health and/or addiction services. The committee works to identify how best to communicate with the general public about the important work that ABH members do in their communities and utilize the best techniques to positively influence the public’s perception of community-based treatment programs.
Meets on an ad hoc basis.
E-Health Committee
The E-Health Committee provides guidance, peer support and resources to ABH members as they undertake the selection and implementation of electronic health record systems. The committee is the successor the e-Health Steering Committee and sub-committees that were formed in 2006 to frame and initiate ABH’s e-Health Initiative.
Meets every other month.
