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Morning Briefing

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Wednesday, Aug 7 2019

Full Issue

Sen. Casey's Frustration With CMS About Quality Of Care From Medicaid Contractors Bubbles Over After Tense Meeting With Centene

Sen. Bob Casey (D-Pa.) wants CMS regulators to look into Medicaid managed care companies that he says are prioritizing profits over patients. After meeting with Centene, the nation’s largest Medicaid managed care company, Casey was appalled. “I thought they would try to persuade me that they were going to do better, but they didn’t seem interested in that at all," he said. Meanwhile, advocates fear that if an Obama-era rule is dropped from Medicaid there won't be enough providers to care for the low-income patients.

ProPublica/The Dallas Morning News: Are Trump’s Top Medicaid Regulators Ignoring Major Problems? Insurance Giant’s Tense Meeting With A Senator Adds To Growing Concern.

The ranking member of the Senate health committee has complained for months about the Trump administration’s failure to look into Medicaid contractors that have reaped big profits while sometimes failing to provide crucial patient services. So last week, Sen. Bob Casey, D-Pa., called in the top boss of Centene, the nation’s largest Medicaid managed care company. He wanted to question the company about reports that its Texas subsidiary denied life-sustaining care to sick and disabled children — in one case, leaving a baby in foster care to suffer a catastrophic brain injury. (McSwane and Benning, 8/6)

Stateline: Trump Shift, Backed By States, Fuels Fear Of Too Few Medicaid Docs 

The Trump administration wants to drop an Obama-era rule designed to ensure that there are enough doctors to care for Medicaid patients. State health officials say the rule, which requires states to monitor whether Medicaid reimbursement rates are high enough to keep doctors in the program, forces them to spend a lot of time collecting and analyzing data with little benefit. Health care advocates, though, fear that dropping the regulation would enable states to set those payments at a level that would cause some of the 72 million Americans who rely on Medicaid to scramble for health care. Research shows that when reimbursement rates drop, fewer providers agree to accept low-income Medicaid patients. (Ollove, 8/7)

In other Medicaid news —

KCUR: Kansas Officials Put Aetna On Deadline: You're Failing On Medicaid Contract 

State officials have told one of the key players in Kansas’ privatized Medicaid system that it stands in danger of getting fired for not living up to its contract. Aetna Better Health has until Wednesday to tell state officials how it is addressing chronic complaints about delayed payments to hospitals and other problems. A formal letter from the state to Aetna says failure to fix the problems so far means the company’s contract “is in jeopardy of being terminated for cause.” (Llopis-Jepsen, 8/6)

Kansas City Star: Kansas Tells Aetna It May Lose Its KanCare Medicaid Contract

Aetna took over for Amerigroup this year as one of the administrators of Kansas’ privatized Medicaid system, joining existing KanCare companies Sunflower State Health Plan and United Healthcare. The transition has been rocky, and after six months of complaints from medical providers, the Kansas Department of Health and Environment told Aetna officials they have 10 days to figure out how to get their act together. (Marso and Shorman, 8/6)

The Advocate: Louisiana Health Department Suspends Automatic Closure Of Thousands Of Medicaid Enrollees 

The Louisiana Department of Health has temporarily suspended a feature of its new eligibility system that automatically kicked people off the Medicaid rolls if they did not respond to requests for annual renewal information, a move that will keep 75,000 people from losing coverage immediately. Jen Steele, LDH Medicaid director, confirmed Tuesday the agency is suspending the auto-closure feature amid a heightened workload for staffers processing calls and information from Medicaid enrollees. (Karlin, 8/6)

Kaiser Health News: Doctors Argue Plans To Remedy Surprise Medical Bills Will ‘Shred’ The Safety Net

Chances are, you or someone you know has gotten a surprise medical bill. One in six Americans have received these unexpected and often high charges after getting medical care from a doctor or hospital that isn’t in their insurance network. It’s become a hot-button issue in Congress, and high-profile legislation has been introduced in both the House and Senate to make the medical providers and insurers address the billing question and take the consumers out of the dispute. That means doctor specialty groups, hospitals and insurers are among the stakeholders that could be financially affected by the outcome. (Bluth, 8/7)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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