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LexisNexis Risk Solutions to Assist L.A. Care with Its Accurate Provider Directory Compliance Requirements Created by the Centers for Medicare and Medicaid Services and California Senate Bill 137

Owner of One of the Nation’s Largest Provider Databases to Enable the Health Plan to Better Serve Its Members by Maintaining its Provider Directories and Confirming the Accuracy of Existing Data

06/16/2016

LAS VEGAS and ATLANTA – (June 16, 2016) – LexisNexis® Risk Solutions, a leading provider of data intelligence, analytics and technology, today announced that L.A. Care Health Plan, the nation’s largest publicly-operated health plan, will use LexisNexis VerifyHCP from LexisNexis Health Care to ensure the accuracy of the health plan’s provider directories. New Centers for Medicare and Medicaid Services (CMS) regulations allow insurers to be fined for errors in Medicare Advantage plan directories, while California Senate Bill 137 (SB 137) – which goes into effect on July 1, 2016 – requires directories to be updated weekly and available on carrier websites without requiring searchers to create or access an account or commit to signing up for the plan. LexisNexis VerifyHCP assists L.A. Care in meeting these requirements and realizing added value across the enterprise as a result of having the most up-to-date information on providers.    

“L.A. Care’s mission is to provide access to quality health care for Los Angeles County’s most vulnerable, and we take great pride in our ability to do so,” said John Baackes, CEO, L.A. Care Health Plan. “By working with LexisNexis Health Care, which owns perhaps the nation’s largest provider databases, we can improve our provider data quality and make sure our members are able to quickly and easily find the providers they need.” 

Under the agreement, LexisNexis VerifyHCP will help L.A. Care maintain their provider directories with current and ongoing demographic information, as well as key information including office hours, languages supported, whether the provider is accepting new patients, the provider’s Medicare participation status and whether the provider accepts Medicare and Medicaid patients. In addition, LexisNexis Health Care will conduct outreach campaigns to confirm with providers that their directory information is accurate. The outreach campaigns will assist L.A. Care with its compliance with the new CMS regulations, SB 137 and Medicaid marketing guidelines.

“The ability to comply with these key requirements is critical for payers today, but our company is focused on more than compliance,” said Josh Schoeller, Vice President, Client Engagement, LexisNexis Health Care. “We are committed to empowering our customers with accurate data that strengthens downstream workflows, enabling our customers to better serve their members. By investing in data analytics to address the challenges of fast-changing provider data, L.A. Care is demonstrating its leadership in the health payer community, and most importantly, its commitment to serving its members. We look forward to supporting L.A. Care’s provider data and analytics needs and helping to enable their mission.”

To learn how quickly provider data changes, view an infographic titled, “Pitfalls of Health Care Provider Data.”

About LexisNexis Risk Solutions
LexisNexis Risk Solutions harnesses the power of data and advanced analytics to provide insights that help businesses and governmental entities reduce risk and improve decisions to benefit people around the globe. We provide data and technology solutions for a wide range of industries including insurance, financial services, healthcare and government. Headquartered in metro Atlanta, Georgia, we have offices throughout the world and are part of RELX Group (LSE: REL/NYSE: RELX), a global provider of information and analytics for professional and business customers across industries. For more information, please visit www.risk.lexisnexis.com and www.relx.com.

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