CHOICE SelectHealth Passes New York State Department of Health Targeted Survey

CHOICE SelectHealth, VNSNY CHOICE’s Special Needs Plan for HIV-positive Medicaid recipients, underwent a targeted, two-day survey by the New York State Department of Health earlier this week and emerged with no corrective actions required—meaning the health plan received perfect marks on all the operational aspects that the reviewers were examining. “In fact, the survey was originally scheduled for three days,” notes Maureen O’Leary, head of compliance for CHOICE SelectHealth, “but it went so well, the DOH inspectors concluded a day early.”

The survey was looking primarily at how SelectHealth communicates with its members on matters related to utilization, such as authorization denials, and grievance and appeals issues—areas identified for improvement in the DOH’s full-scale survey of SelectHealth, conducted in 2017. “We also did extremely well on that 2017 survey, which lasted a week and was incredibly comprehensive,” says Maureen. “The fact that we had only a few limited areas that DOH wanted to re-examine contributed to our excellent performance in this latest survey.”

In the year leading up to DOH’s re-examination, SelectHealth focused on enhancing its utilization outreach, a process that included establishing a second level of review for utilization-related communications with members. “These outstanding survey results are one more indication of the hard work that CHOICE has done as an organization to ensure that compliance is a key component in every aspect of our operations,” says Dr. Hany Abdelaal, President of VNSNY CHOICE. “The strong compliance program that we’ve put in place demonstrates our commitment to our products and our members.”

“This year’s exemplary survey results, together with last year’s stellar survey performance, speak to the hard work and dedication that the SelectHealth teams put forth on a daily basis,” adds Maureen. “The support of all the different departments makes it easier to meet the myriad regulatory requirements placed upon us by DOH, the AIDS Institute and the Office of Medicaid Inspector General. To all of the SelectHealth teams, a sincere thank you for a job well done!”