skip to Main Content

Government Health Plans

Ensure compliance and optimal member care and service

MedHOK excels at understanding the complex regulatory compliance environment of Government health plans and the overlapping state Medicaid rules that often apply. Government programs have been a strong focus of MedHOK since our inception—providing us with unparalleled experience to help clients ensure plan compliance and optimal member care and service.

  • Out-of-the-box solutions are mapped to government compliance requirements
  • Dedicated staff of subject-matter experts offer consultative support and best-practice recommendations
  • Proactive tracking of emerging regulatory landscape ensures customer plans are prepared for change
  • Hundreds of successful Medicare and Medicaid compliance audits demonstrate proven performance with stellar CMP and audit ratings
  • 40% of all 2018 4-star and above Medicare contracts use the MedHOK Clinical Platform
  • Seven of the fifteen 2018 MAPD 5-Star contracts use MedHOK MarketProminence
  • Close to 30% of all Medicare Advantage and Part D lives (12.5 Million) are administered on MedHOK MarketProminence
MedHOK offers integrated solutions for all Government health plans: Medicare Plans
  • Medicare Advantage and Part D
  • Medicare Advantage Part C Only
  • Medicare Advantage EGWPs
  • Medicare Advantage Dual Eligible SNPs
  • Medicare Advantage Chronic Care SNPs
  • Medicare Advantage FIDE/FIDA
  • Medicare-Medicaid
  • Stand-alone Part D
  • Stand-alone Part D EGWP
Medicaid Plans
  • Medicaid Plans, including TANF, SSI, SCHIP, and Waiver
  • Medicaid Managed Long-Term Care
Marketplace/Exchange Plans
  • Individual On Exchange and Off Exchange
SHOP Plans

Featured Resources

Back To Top