Medicaid Member Engagement Committee (MMEC)

Agenda

Welcome & Icebreaker

• Roll call
• Meet & Greet
• Icebreaker

Discussion

• Question for all: What is your biggest concern for Medicaid?
• Review Medicaid Member E-Newsletter
• Q&A
• Open Discussion
• Decisions

Next Steps

• Reminder for Next Meeting
• Annual Agenda

Minutes

Welcome & Icebreaker

• Meeting called to order at: 9:32am
• Meeting adjourned: 10:50am
• Roll call of committee members in attendance: 
  • Eldor Scheid
  • Allie Browning
  • Victoria Alexander
  • Kara Hanson
  • Jacqueline Frost
• Members Absent: 
  • Heather Skadsem
• Introduction and welcome to the first meeting
  • Meet & Greet
  • Icebreaker

Discussion

• Question for All: What is your biggest concern with Medicaid?
  • Eldor: The change from county representatives to state workers. When calling in, members do not get the same worker and notes are not summarizing the last call to save the member from repeating information. Appeal experience is not pleasant. Medicaid does not seem responsive. 
  • Kara: Information availability: What does Medicaid cover such as equipment? Increased clarity on covered and non-covered services. 
  • Victoria: The lack of services I am getting such as glasses options, dentist availability, etc. These are my basic needs that are not being met.  
  • Jacqueline: Medicaid is so limiting. The whole picture is not considered. Denials for out-of-state specialist are a large barrier. Specific equipment is not always covered.
  • Allison: The lack of dental, vision, and transportation. There is a lack of providers for transport. Client share is too high to work with.  
• Review E-News
  • Members will review January E-Newsletter and attend the next meeting with notes.
• Q&A
  • Is the website able to search just the Medicaid Member Handbook?
    • Jen to follow up with Communications department.
  • Can a chat box be developed for the website to offer live assistance with navigating the website and answer general Medicaid questions (alternative to calling and experiencing long wait times with call center)?
    • Jen to follow up with Communications department.
  • Can we program the HHS website so that if certain words are searched it will lead to the Medicaid Member Handbook?
    • Jen to follow up with Communications department.
  • How often does the Provider Directory get updated? What are the future plans for these documents with the PCCM program ending?
    • Jen to follow up.
• Open Discussion
  • What are our main focuses?
    • Navigating coverage
      • Increase coverage information
        • What is covered
        • When coverage is allowed
      • Specialist/guide/health care coach to assist members in understanding how to organize complex health care needs:
        • Specialty/complex health care needs: Out-of-state referrals, billing, referrals, covered services, and equipment, appeals, etc. 
        • Help from specialist could be by appointment, with notes, and ability for members to return to the same specialist
        • Initiated in welcome letter and Health Tracks initial contact.
    • Navigating website
      • Chat box for live assistance in website navigation or general Medicaid questions to avoid long wait times when calling into call centers
      • Finding providers, user friendly provider lists
      • Can our searches lead to the Medicaid Member Handbook based on frequently used words (find a dentist, coverage, etc.)?
    • Medicaid coverage 
      • Transportation
      • Reimbursement to driver per person not per ride
      • Coverage for glasses/vision to include transition (no line) bifocal lenses. Allow for Medicaid to cover set cost for frames/lenses and member to choose to pay for remaining cost of frames/lenses they desire. 
  • What are our current tasks?
    • Medicaid Member Handbook review
      • Details on finding a dentist, vision, etc. to include www.insurekidsnow.gov
        • Instructions to ask if provider is currently accepting Medicaid and taking new clients
        • Links to provider lists
    • Medicaid Member E-News review
      Find a person, with limited/no exposure to www.hhs.nd.gov to navigate website to Medicaid information and give honest feedback
• Decision
  • Current focus
    • Navigating coverage
    • Navigating website
    • Medicaid coverage expansion
  • Current tasks
    • Handbook review
    • E-News review
    • Website navigation testing

Next Steps

• Reminder for next meeting
  • May 7, 2024 @ 9:30-11:320a
• Annual agenda
  • March 5, 2024
  • May 7, 2024
  • July 9, 2024
  • September 10, 2024
  • November 5, 2024

MMEC Meeting Minutes 3/5/24

Agenda

Meet & Greet and Icebreaker

• Roll call
• Meet & Greet
• Icebreaker

Discussion

• Last meeting's follow-ups
• New topics
• Q&A
• Open Discussion

Next Steps

• Reminder for Next Meeting
• Annual Agenda

Minutes

Meet & Greet and Icebreaker

• Meeting called to order: 9:30am
• Meeting adjourned: 11:30am
• Roll call of committee members in attendance:
  • Victoria Alexander
  • Kara Hanson
  • Eldor Scheid
  • Jacqueline Frost-Hodney
  • Heather Skadsem
  • Allison Wanner
• Members Absent: 
  • Jon Fettig
• Also in attendance:
  • Mandy Dendy, Policy Director
  • Monique Runnels, ND Medicaid Tribal Liaison
• Introduction and welcome for new membersIcebreaker

Discussion

• Last meeting's Follow-ups
  • MMEC made suggestions for staffing and features to enhance communication between members and ND Medicaid. They asked:
    • Can we create a chat box on our website that can assist visitors with website navigation and general Medicaid questions?
      • We are looking into this.
    • Can a search bar for just the Medicaid Member Handbook be created within the handbook or its webpage?
      • We are looking into webpage-specific search bars.
    • Can specific words be typed into the main search bar to lead visitors directly to handbook?
      • We are looking into this.
  • MMEC raised concerns about coverage of specific services.
    • Can members pay for the difference between a non-transition bifocal and a transition bifocal because this lens is not covered by ND Medicaid?
      • Discussed medical necessity and Medicaid coverage of items that meet a member’s needs and currently this is not an option.
      • An SFN form to request increases to coverage for specific items was shared. 
      • We reviewed ways for members to more easily access information through the handbook.
    • MMEC recommends increasing reimbursement for transportation.
      • Provider rates will be increased effective July 2024
      • There will be an article on non-emergency transportation in a future E-Newsletter issue.
  • MMEC recommends offering a Care Specialist/Guide Position for members with complex health needs to help guide them in finding the right care.
    • MMEC was asked,” What members would need this position outside of members who are assigned a case manager?”
      • No MMEC members have had experience having a case manager with Medicaid, though several are caregivers of members with complex health needs.
    • MMEC discussed best practices by commercial insurance companies such as auto-assignment of a case manager and frequent check-in’s by case manager.
    • MMEC suggests ND Medicaid could auto-assign a case manager based on a member’s diagnoses or medical treatment frequency.
    • MMEC suggested that case managers could reduce cost to ND Medicaid by assisting members in knowing where to go for treatment vs. seeing multiple providers to find the care they are needing.
    • MMEC was asked if primary care providers could fill this care coordination role and members thought this wasn’t always an option. 
  • MMEC reviewed the ND Medicaid provider list and asked questions.
    • How often are provider lists updated?
      • These lists are updated monthly. 
    • What will be the layout of the provider lists now that the Primary Care Case Management (PCCM) program has ended?
      • We are currently working on improving the user-friendliness for these lists.
• New topics
  • We reviewed the purpose of the MMEC and how we can impact ND Medicaid members.
    • MMEC should focus on topics that affect the majority of ND Medicaid members.
    • MMEC can increase member knowledge of ND Medicaid practices.
  • MMEC members were asked to test the hhs.nd.gov website and reported:
    • Some found use and navigation easy while others were confused and unintentionally re-directed to other locations on the website.
    • Not all MMEC members were able to complete this task.
    • Members didn’t identify any shared areas of concern at this time.
  • MMEC reviewed the last issue of the E-Newsletter and recommends:
    • Short length, enticing titles, keeping imagery, and keeping links.
    • Placing a URL on the E-Newsletter flyer.
    • Social media posts of E-Newsletter articles would be beneficial.
    • MMEC was asked suggest topics for future E-News articles. 
  • MMEC reviewed the Medicaid Member Handbook (chapters 1-4) and made the following recommendations:
    • Add directions/links for members of Medicare and BCBS Expansion to find correct webpage.
    • Language translation should be more prominently displayed on the webpage or in the handbook.
    • Add a ‘close’ button under each section to avoid scrolling back up to close sections.
    • Keep less content in chapters and use links for more information when needed.
    • Add more detailed information on covered services in this document, reducing need to use the call center to find information.
      • We are exploring ways to strike a balance between too much information and not enough information.
    • Include a list of non-covered services.
    • Include a pdf version for printing capabilities.
    • Add general Non-Emergency Medical Transportation information and rates to reduce calls into call center.
    • Add instructions for viewers of the Provider Directory to call their chosen provider to see if they are taking new patients and accepting Medicaid.
      • Additions have been made to the handbook draft.
• Q&A
  • Do Medicaid and IHS work together or separate?
    • Monique Runnels briefly described how tribes bill differently, how referrals work, and tribal care coordination.
  • Is there a way to request a case manager?
    • We are looking into this.
  • What does Medicaid offer for guide/support?
    • We are looking into this.
• Open Discussion
  • MMEC shares that there needs to be more information on Medicaid and IHS for members.
    • Monique shares that we are conducting tribal consultations and care coordination agreements are in place.
    • We will work on future content within the handbook and E-Newsletter.
  • MMEC shared that members need help and guidance with appeals. They shared:
    • The process is intimidating and confusing for members.
    • Past experience showed that there was no advocate present for members during appeals.
    • Requesting documentation takes up to 30 days but you only have 30 days to file an appeal. The window of opportunity could close before documentation is ever received. 
    • There needs to be clearer, more encouraging, helpful explanation of the appeals process. 
    • MMEC recommends exploring best practices for appeals processes for commercial insurance companies.
  • MMEC shared Self Service Portal concerns.
    • Tabs in the SSP look like they can’t open but they do. MMEC recommends making this feature more obvious.
  • Coverage concerns
    • MMEC recommends that hearing aids, frequency of cleanings, and equipment have more coverage.
      • Recent audiology policy update, effective 4/1/24, addressing age, diagnoses, removal of PCP referral requirement, and more was shared with MMEC. Leadership shared with the MMEC that policy changes were made after surveying audiology providers.
    • Information about Non-Emergency Medical Transportation (NEMT) providers needs to be more easily accessible to members, promoted more, and easier to understand.
      • We will have content in the handbook and will consider an article for the E-Newsletter.
    • MMEC expressed concerns for providers experiencing difficulties with length of wait for reimbursements. They feel this deters providers from partnering with ND Medicaid. 
  • Do we want to request a guest speaker?
    • Out-of-State Coverage
    • Behavioral Health
    • Medicaid and BCBS Expansion
    • Recipient liability
    • Medicare and Medicaid dual coverage

Next Steps

• Reminder for next meeting
  • July 9, 2024 @ 9:30-11:320am
• Future meetings
  • September 10, 2024
  • November 5, 2024

MMEC Meeting Minutes 5/7/24

Agenda

Minutes

Agenda

Minutes

Agenda

Minutes

ND Medicaid values member and family participation in improving the Medicaid member experience. The Medicaid Member Engagement Committee (MMEC) is a way for members to share their lived experience, give input, and bring positive change to ND Medicaid.

The MMEC is designed to meet the following objectives: 

• Prioritize person and family centeredness, which means we respect and value individual strengths, preferences, and contributions, and work with members, not doing things to or for them.
• Provide opportunities for collaboration between ND Medicaid and members with the goal of improving member experience and the relationship between ND Medicaid and all members.
• Provide a way for ND Medicaid to test if programs, policies, and materials are working as designed and having the desired outcome.

Discussion and recommendations from the MMEC will help guide ND Medicaid and will be shared with the Medicaid Medical Advisory Committee, ND Medicaid Leadership, and ND Department of Health and Human Services Leadership. 

The MMEC will have 12 members. ND Medicaid seeks to have members with different backgrounds, geographical areas, and with different life experiences and situations represented on the MMEC. ND Medicaid encourages all Medicaid members interested in serving on the MMEC to apply. 

Who Should Apply

ND Medicaid encourages current Medicaid members, people who have had Medicaid within the last three (3) years or are caring for a Medicaid member to apply for the MMEC. 

Note: Medicaid Expansion members are not eligible to serve on the MMEC but can share their views on Medicaid Expansion with the Medicaid Expansion Member Advisory Committee. 

Medicaid is also different than Medicare. There are many people who have both Medicare and Medicaid, and we will welcome those members if they have experience with Medicaid. 

How to Join the MMEC

People applying to join the MMEC are called applicants. All applicants will apply to the MMEC by submitting an application. If you need help with the application, you can ask the Member Liaison for help by calling 701-328-8666 or emailing jsheppard@nd.gov 

Selecting a New Member to be on the MMEC

ND Medicaid will review applications and interview selected applicants to ensure membership is diverse and represents the ND Medicaid population.  Applicants will meet with the Member Liaison for a short interview. The Member Liaison will recommend applicants for the MMEC to the Medicaid Director. The Medicaid Director will appoint members to the MMEC.
LEARNING ABOUT THE MMEC
All new members of the MMEC will meet with the Member Liaison. The Member Liaison will review what to expect at MMEC meetings, show individuals how to use technology to participate in MMEC meetings, and go over recent topics discussed at MMEC meetings. 

Membership Terms

The time a member serves on the MMEC is call a term. To start, ND Medicaid will stagger member term length: 
 

• Six members will be asked to serve for one year. This will allow new members to join and have experienced members serve with them. 
• Six members will be asked to serve for two years. This will allow the MMEC to be made of experienced members while welcoming new members.

After the first initial term, all MMEC terms will be 2 years.

Members may serve a second term. If a member wants to serve a second term, they will need to apply and will be evaluated alongside other applications. Members are limited to serving two terms.

Chairperson

A chairperson may be chosen from current MMEC members and will serve a one-year term. The chairperson will: 

• Help the Member Liaison organize and plan meetings,
• Find guests to share information, and 
• Run the meeting. 

Resignation and Removal

Resignation is when a member feels they need to leave the MMEC before their term is ending. If a member cannot be on the MMEC anymore, a seat will be opened.  

Members may be removed from their seat on the MMEC for good cause. Examples of good cause are: 

• Excessive absences from MMEC meetings.
• Misconduct during MMEC meetings.

Benefits

We value our MMEC members! While you are on the committee:

• Medical Services offers members direct access to our resources and staff while they serve their term. Please contact the Member Liaison to learn more.

MMEC members that fulfill their commitment:

• Will be able to ask for a letter of recommendation from our Member Liaison
• Can use the Member Liaison as a professional reference. 

These are helpful when you are applying for a job or other committee-like work.

Release of Information

ND Medicaid may request that members sign a release allowing a picture, the name, and/or basic information about the member to be published on the www.hhs.nd.gov website.

The MMEC will meet online every other month. Meetings will be held by Teams with an option for individuals to join the meeting by phone. Meetings will last no more than 2 hours.

Additional meetings will be held as needed when requested by committee members.

ND Medicaid will publish a yearly schedule for MMEC meetings. The meeting schedule will be posted on the MMEC website. 

Attendance

ND Medicaid encourages members to attend every meeting to the best of their ability. ND Medicaid asks each MMEC member to commit to attending at least 4 meetings a year. If a MMEC member misses more than 3 meetings, ND Medicaid may work with the member to determine if they are able to participate or if another Medicaid member should attend the MMEC in their place.

Meeting Minutes

Meeting minutes are notes of what was talked about at a meeting. Minutes will be taken at every meeting. ND Medicaid will summarize topics, suggestions, and follow up on progress. Minutes will be posted on the MMEC website. 

Disability and Other Accommodations

ND Medicaid will assist members with accommodations such as American Sign Language (ASL) translation, captioning, and caregiver participation for members with barriers. ND Medicaid encourages members to tell the Member Liaison about any assistance they will need to attend and participate in the MMEC meetings. 
ND Medicaid will also make accommodations for written or recorded materials presented at meetings such as translation, captions, descriptions of pictures, etc.

ND Medicaid values the feedback of Medicaid members and their families. The MMEC asks members to share their lived experiences with each other and others attending MMEC meetings and give all members a chance to be heard. ND Medicaid asks members of the MMEC to act in good faith with each other and agree to a set of guidelines for how the MMEC will interact with each other. This includes being honest and not doing things that will harm the MMEC. It also includes behavior outside of meetings. Expectations include:

• Members should try to attend and actively participate in all meetings. If members cannot attend a meeting, they are requested to advise the ND Medicaid Member Liaison. After missing a meeting, the member should plan to meet with Member Liaison to go over what happened at the meeting.
• Members agree to be respectful of other MMEC members, ND Medicaid staff, and other presenters. They will listen to each other and seek to understand the other’s perspectives, even if they disagree.
• Members agree to make every effort to share their feedback and experience and bring forward any concerns. 
• Members agree to refrain from personal attacks, purposefully harming the MMEC, and publicly criticizing or mis-stating information shared by other MMEC members during the meeting.
• Any written communications, including emails, blogs, and other social networking media (Ex. Facebook, Instagram), will follow these same guidelines and will maintain a respectful tone even if highlighting different opinions.

Member Liaison
Jen Sheppard
jsheppard@nd.gov | 701-328-8666

Alternative Contact
Mandy Dendy
mrdendy@nd.gov

The MMEC Guidelines inform members of this committee's purpose, how our meetings are held, and what membership looks like.