Program Development

Managed Healthcare Unlimited (MHU) partners with regulatory agencies to provide the foundations for new and innovative managed care programs created by health plans and by state, county, and city governments often in response to new legislation, including the Patient Protection and Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act (MHPAEA).

  • MHU implemented the federal Mental Health Parity and Addition Equity Act (MHPAEA) in California, partnering with the California Department of Managed Health Care. Together the team developed strategies, processes, policies, and procedures to operationalize the program across 26 health plans. MHU designed program documents, provided assistance to health plan staff as they moved through the implementation process, and conducted inaugural audits to determine of plan operations met regulatory requirements.
  • MHU reviewed the Northwest Pennsylvania AIDS Planning Coalition efforts to evaluate the role of faith-based organizations in providing services to victims of HIV/AIDS under a federal grant. MHU performed a needs assessment, conducted strategic planning sessions, developed study methodology, designed data collection tools, collected and analyzed data, and prepared a report containing findings and recommendations.
  • MHU conducted reviews of new Medicaid managed care programs developed by California counties under a federal waiver (Section 1115[a] of the Social Security Act) that permits mandatory enrollment of Seniors and Persons with Disabilities into a state-wide managed care program.
  • MHU assisted in the development of California’s Timely Access Regulations (TAR), which measure and monitor health plans’ standards for access and availability of services.
  • MHU implemented the California Mental Health Parity Act for seven major state-regulated health plans.
  • MHU co-authored the following Technical Assistance Guides, which serve as audit tools to measure health plans' performance against California’s Knox-Keene Health Care Service Plan Act requirements. The guides have become standard references for industry reviews:
    • Routine Medical Surveys of full-service plans, dental plans, vision plans, behavioral health plans, and employee assistance programs
    • Assessment of Health Plan Management of Claims
    • Guide/Review Protocol for Review of Evidences of Coverage (EOCs)
    • Review of Evidence of Coverage and Disclosure Forms
    • Review of Provider Contracts
    • Non-Routine Surveys to Detect Post-Claims Underwriting


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