New Program Offers Millions in Potential Savings
DALLAS, March 6 /PRNewswire-FirstCall/ -- State Medicaid programs can potentially save millions of dollars annually through an innovative initiative of Affiliated Computer Services, Inc. (NYSE: ACS) and RxHub, LLC. The proprietary program helps ACS' healthcare clients avoid costly, manual recovery of drug claims from commercial insurers.
The new program enables pharmacies to immediately identify pharmacy benefit coverage at the point-of-sale. This eliminates the costly, inefficient "pay and chase" programs state Medicaid agencies currently use to recover monies when other insurance coverage is discovered.
"The potential savings identified through this new program is another way in which ACS provides innovative technology to our state partners to help reduce the costs of administering their Medicaid programs," said Christopher T. Deelsnyder, ACS senior vice president and managing director, Government Healthcare Solutions.
Federal law requires that commercial insurers pay before Medicaid pays on claims of beneficiaries who are also covered by Medicaid. In today's paper-based world, it is difficult to determine if Medicaid beneficiaries also have commercial insurance coverage when they receive care.
Once state Medicaid agencies have determined that a potentially liable third party exists, they must either try to avoid those costs or resort to "pay and chase," in which the state agencies pay beneficiaries' medical bills and then attempt to recover whatever portion of the claims are owed by commercial insurers. This complex process often takes months and yields a very small percentage of the millions of dollars due to the states each year.
The new program enables the pharmacist to check benefit coverage at the point-of-sale using ACS' proprietary SmartPA(SM) prior authorization solution. This is done in real time while the prescription is being processed by systematically checking St. Paul, Minn.-based RxHub's Master Patient Index (MPI). It permits almost instantaneous identification of any coverage by commercial insurers and allows pharmacies to bill them instead of Medicaid. The RxHub MPI contains access to more than 200 million patient records. The program was launched in February 2008.
"This program could eventually eliminate the need for 'pay and chase' pharmacy recovery programs in all state Medicaid programs," said J.P. Little, chief operating officer of RxHub, LLC.
RxHub (http://www.rxhub.net) provides authorized clinicians with secure access to real-time, patient specific prescription information for more than 200 million Americans within the United States. Prescription eligibility, formulary and benefits, and medication history information is provided -- for consenting patients -- to authorized clinicians at the point of care. This real-time decision support information is used by clinicians to effectively manage the patient's use of medications and enables the most clinically appropriate and cost effective medication therapy to be electronically prescribed for the patient. RxHub partners with prescription payers, technology providers, and pharmacy networks to improve patient safety, increase workflow efficiency and reduce the overall cost of health care delivery.
ACS is a national leader in state healthcare program administration, offering a full spectrum of systems and complementary services through an integrated solution, from care management solutions and child health programs to pharmacy benefits management and traditional Medicaid fiscal agent services. ACS supports more than 23 million program recipients and processes nearly 550 million Medicaid healthcare claims annually, representing close to $50 billion in provider payments. As the nation's largest government program pharmacy benefits administrator, ACS serves 28 states, the District of Columbia, and the Department of Labor with drug expenditures totaling more than $13 billion.
ACS, a global FORTUNE 500 company with 62,000 people supporting client operations reaching more than 100 countries, provides business process outsourcing and information technology solutions to world-class commercial and government clients. The company's Class A common stock trades on the New York Stock Exchange under the symbol "ACS." Learn more about ACS at http://www.acs-inc.com.
The statements in this news release that do not directly relate to historical facts constitute "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995. These statements are subject to numerous risks and uncertainties, many of which are outside the Company's control. As such, no assurance can be given that the actual events and results will not be materially different than the anticipated results described in the forward-looking statements. Factors could cause actual results to differ materially from such forward-looking statements. For a description of these factors, see the Company's prior filings with the Securities and Exchange Commission, including our most recent filing. ACS disclaims any intention or obligation to revise any forward-looking statements, whether as a result of new information, future event, or otherwise.
|SOURCE Affiliated Computer Services, Inc.|
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