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2022 Medical Necessity Webinar Series - OnDemand
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Description

  

Course Description:

The Catalyst Center and the National Coordinating Center for the Regional Genetics Networks, two programs supported by the Health Resources and Services Administration, are pleased to announce a three-part webinar series to help the genetics community better understand how they can navigate medical necessity. This webinar series will provide information about medical necessity through the lens of genetic cases.

Target Audience:

Healthcare Providers, Public Health Professionals, Individuals/Families

 

Medical Necessity Webinar Series Part 1 - Define and Discuss the Use of Evidence to Form Medical Necessity Criteria and Policy

Date of Release: May 12, 2022

Expiration Date: May 31, 2024

Credits offered: CME

Estimate time of completion: 1 hour

Course must be completed by the expiration date

 

Learning Objectives:

 

At the conclusion of this session, participants should be able to:

  • Define what is medical necessity.
  • Describe how evidence is evaluated to determine whether a test or service is deemed medically necessary.
  • Explain how the evaluation of benefits and costs to families and to payers are considered when determining medical necessity policy.

 

Medical Necessity Webinar Series Part 2 - Medicaid and Early and Periodic Screening, Diagnosis, and Treatment (EPSDT)- The Title V and Medicaid Relationship

Date of Release: May 25, 2022

Expiration Date: May 31, 2024

Credits offered: CME

Estimate time of completion: 1 hour 

Course must be completed by the expiration date

  

Learning Objectives:

 

At the conclusion of this session, participants should be able to:

  • Explain how EPSDT sets a standard for care for children and youth and its relationship to medical necessity
  • Compare the relationship of Title V and Medicaid for supporting coverage and access to services in states.
  • Define the first steps in the process of getting prior authorization for medically necessary services

 

Medical Necessity Webinar Series Part 3- Practical Application of Medical Necessity: Understanding Prior Authorization Process, Requesting Authorizations, and Denials and Appeals

Date of Release: June 27, 2022

Expiration Date: May 31, 2024

Credits offered: CME

Estimate time of completion: 1 hour 

Course must be completed by the expiration date

The Catalyst Center (Grant U1TMC31757) is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $500,000, with no financing by nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government.

 

The National Coordinating Center for the Regional Genetics Networks is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under Cooperative Agreement #UH9MC30770 from 6/2020-5/2024 for $800,000 per award year. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

Planning and Faculty

Contributors:  

Erin Beaver, MS, CGC

Licensed Certified Genetic Counselor

Missouri Baptist Medical Center

 

Julie Kaylor, MS, CGC

Director, Medical Affairs, Managed Care

Guardant Health

 

Nicole Guysi

Family Leader

Demeatrice Nance, CCHW

Research Coordinator

Pediatric Institute

Cleveland Clinic Children’s

 

Tammy Jones

Program Coordinator

Genetic Metabolic Nutrition Research & MNT4P Program, Emory University

Jeff Schiff, MD, MBA

Senior Scholar

AcademyHealth

Accredited Continuing Education Information

Accredited Continuing Education Information:

Continuing Medical Education (CME AMA & CME Other)

 

Accreditation

The American College of Medical Genetics and Genomics is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

 

Credit Designation

The American College of Medical Genetics and Genomics designates this enduring activity for a maximum of 3 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Claiming your Educational Credits

This activity consists of: View content, take a post-test, the test may be taken as often as necessary to achieve a passing score of 80% or better is required to receive credit.  If you do not achieve a passing score, the program will identify which questions you answered incorrectly so that you can review the module and try again. Complete the evaluation form.

Financial Disclosures

Accredited Continuing Education Financial Disclosure

The American College of Medical Genetics and Genomics (ACMG) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide Accredited Continuing Education (ACE) for physicians. ACMG is an organization committed to improvement of patient care and general health by the incorporation of genetics and genomics into clinical practice.

ACMG has implemented the following procedures to ensure the independence of ACE activities from commercial influence/promotional bias, the Accreditation Council for Continuing Medical Education (ACCME) requires that providers (ACMG) must be able to demonstrate that: 1) everyone in a position to control the content of an ACE activity has disclosed all financial relationships that they have had in the past 24 months with ineligible* companies; 2) ACMG has implemented a mechanism to mitigate relevant financial relationships; and 3) all relevant financial relationships with ineligible companies are disclosed to the learners before the beginning of the educational activity. The learners must also be informed if no relevant financial relationships exist.
*Ineligible companies are defined as those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

 

ACMG Education Policies

Please review the policies below regarding the ACMG Education program

 

All of the relevant financial relationships listed for these individuals have been mitigated.

 

Name

Program Committee Member

Presenter
Panelist
Moderator

Peer Reviewer

Financial Disclosure Relationship/Company

Baughman, Allyson

X

   

Nothing to disclose

Beaver, Erin

X

X

 

Nothing to disclose

Caisse, Molly

X

 

 

Nothing to disclose

Comeau, Meg

X

 

 

Nothing to disclose

Ginsburg, Susanna

X

 

 

Nothing to disclose

Guysi, Nicole

X

X

 

Nothing to disclose

Jones, Tammy

X

X

 

Nothing to disclose

Kaylor, Julie

X

X

 

Employment and Stock, Guardant Health

Lyon, Megan

X

 

X

Nothing to disclose

Nance, Demeatrice

X

X

 

Nothing to disclose

Schiff, Jeff

X

X

 

Nothing to disclose

 

Disclaimer

ACMG educational programs are designed primarily as an educational tool for health care providers who wish to increase their understanding of the application of genomic technologies to patient care. The ACMG does not endorse or recommend the use of this educational program to make patient diagnoses, particular by individuals not trained in medical genetics. Adherence to the information provided in these programs does not necessarily ensure a successful diagnostic outcome. The program should not be considered inclusive of all proper procedures and or exclusive of other procedures and that are reasonably directed at obtaining the same results. In determining the propriety of any specific procedure or, a healthcare provider should apply his or her own professional judgment to the specific clinical circumstances presented by the individual patient or specimen.

Questions regarding CE credit should be directed to education@acmg.net

Summary
Availability: On-Demand
Expires on 05/31/2024
Cost: FREE
Credit Offered:
3 CME (AMA) Credits
3 CME (Other) Credits
Contains: 3 Courses

© 2022 American College of Medical Genetics and Genomics. All rights reserved.

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