Medicaid Quality Management
Office of Medicaid Program Oversight (MPO)

The mission of the Office of Medicaid Program Oversight (MPO) is to optimize the use of Medicaid resources through analysis and evaluation of costs, delivery, outcomes of services and Agency functions. Its vision is to maximize the efficiency and effectiveness of Medicaid programs. Some of the services that the MPO team will provide are:

Internal:

• In-house assessments of selected Medicaid programs through the following activities:
• Develop standards and tools for effectively monitoring Medicaid services;
• Develop standards for data exchange and data use agreements;
• Prevent unnecessary and inappropriate utilization of Medicaid services;
• Reduce duplication of Medicaid services;
• Ensure our FMMIS agrees with Medicaid program operations;
• Review program policies to ensure appropriateness of edits in our FMMIS;
• Ensure compliance of program operations with policy;
• Compare various alternative managed care models/programs;
• Sample claims and eligibility for analyses of programs and services;
• Run trends for various programs; and
• Identify best practices and make recommendations based on findings.
• Special Projects
• Medicaid Reform
• Coordinate activities across Medicaid Bureaus to avoid duplication of efforts and ensure efficiency.
• Develop website for dissemination of materials for internal consumption.
• Coordinate Medicaid activities for the Agency’s Long Range Program Plan.
• Compile a Medicaid Corrective Action Plan for the Payment Accuracy Study.

External:

• Ensure Medicaid network adequacy and provide visualization through geographic information systems
• Improve access to Medicaid primary care providers and specialists.
• Strengthen Medicaid provider relations to ensure retention.
• Physician profiling.
• Conduct site visits
• Random site visits (required by statute)
• Targeted site visits (based on analyses)
• Analyze targeted Medicaid programs/services
• Coordinate activities with our Field Office Managers (FOMs)
• Coordinate activities with Medicaid Program Integrity.

Staff on the MPO team are:

Karen Chang, M.S.
AHCA Administrator

Jamie Bennett
Consultant

Beverly Carr
Consultant
EDS / APS

Matthew Cooper
OPS Research Analysis

John Kane
APS /EDS Program Analyst

Michael Karris
OPS Research Assistant

Chris Mallison
Research Associate

Jason Ottinger
Government Analyst II

Michael Roberts
Government Analyst II

David Royce
Government Analyst II

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Quality Unit

Debby McNamara
Senior Management Analyst Supervisor

Stephen Bradley, M.H.A.
Government Analyst II

Leilani Hildinger
Word Processor Systems Operator

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