TennCare Contracts with CAQH UPD to Collect Provider Data

Use of UPD could serve as model for other Medicaid programs

WASHINGTON, May 11, 2011 /PRNewswire/ -- CAQH® announced today that TennCare, the Tennessee Medicaid program, has contracted with CAQH to use the Universal Provider Datasource® (UPD®) to collect healthcare provider data for credentialing. TennCare will also use UPD SanctionsTrack™, to monitor comprehensive sanctions and disciplinary actions data for its healthcare professionals.  TennCare is one of the oldest Medicaid managed care programs in the country and one of two programs that enrolls the entire state Medicaid population in managed care.

"TennCare's implementation of UPD reflects on the accuracy and currency of the data in the system, which is being used by more than 900,000 providers in the U.S. to self-report and maintain their information," said Robin Thomashauer, executive director at CAQH.  

State Medicaid agencies can leverage UPD for provider data needs beyond credentialing.  TennCare's contract with CAQH allows for the option of utilizing UPD as the source of provider-related data for the state health information exchange (HIE) directory or emergency registration repositories through the Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP).  In addition, SanctionsTrack has the potential to help ensure providers who apply for meaningful use funds are eligible to receive payments.  

TennCare joins several other state Medicaid agencies that also use UPD: Kentucky, Pennsylvania, and New York.  

About CAQH

CAQH serves as a catalyst for industry collaboration on initiatives that simplify healthcare administration for health plans and providers, resulting in a better care experience for patients and caregivers. CAQH helps promote quality interactions between plans, providers and other stakeholders; reduce costs and the frustrations associated with healthcare administration; facilitate administrative healthcare information exchange and encourage administrative and clinical data integration. An initiative of CAQH, the Universal Provider Datasource (UPD) is an online data collection service that today supports over 900,000 physicians and allied healthcare professionals.  Visit www.caqh.org for more information.

About TennCare

TennCare is the State of Tennessee's Medicaid program that provides health care for 1.2 million Tennesseans and operates with an annual budget of approximately 8 billion dollars.

SOURCE CAQH

Suggested Articles

Regardless of who wins the elections in November, there are three issues that are going to dominate the healthcare discussion in Congress in 2021.

A new CMS report estimates that premiums for the second-cheapest silver tier plan will decline by 2% on HealthCare.gov next year.

Premiums on the ACA's exchanges for 2021 are expected to rise by about 1% as insurers struggle to figure out the impact of COVID-19, KFF report finds.