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IFMC to Manage Minnesota's Medicaid Utilization Management Program
Date:6/30/2011

WEST DES MOINES, Iowa, June 30, 2011 /PRNewswire/ -- The Minnesota Department of Human Services has selected IFMC to operate the Medicaid Utilization Management Program for the State of Minnesota.  The contract with IFMC, which begins July 1, 2011, is a two-year agreement with a possible two-year extension that could follow.

The utilization management program includes two major components:

- Service Authorizations - IFMC will conduct reviews for medical services proposed for delivery to Medical Assistance members.  These reviews will be performed for all services specified by the state that are subject to prior authorization including certain medical procedures, dental services, adult and children mental health services and home care services.  

- Utilization Management - IFMC will conduct concurrent and retrospective review of cases involving hospital care for Medical Assistance members to determine if the services were medically necessary and met professional standards for the quality of care.  Cases in this category include hospital admissions for inpatient care, hospital re-admissions, short hospital stays, long hospital stays (60+ days) and extended stays in psychiatric facilities.

In order to fulfill the contract requirements, IFMC has developed a local presence by opening an office in Bloomington, MN.   Personnel working on the program will include physicians, Registered Nurses (RNs), and other medical professionals licensed in the State of Minnesota.  

"We are looking forward to working with the State of Minnesota," says Mike Speight, Senior Director at IFMC.  "We have experience working with programs similar to this, and are eager to make a difference in the lives of Minnesota residents."

IFMC is an experienced, national leader with significant expertise in utilization management and in working with state Medicaid programs.  

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