MM Curator summary
The Senate insistence on reinstating Paramount as an MCO no jeopardizes various improvements to the program.
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
COLUMBUS, Ohio — A plan to revamp Ohio’s Medicaid managed care system could be thrown off course.
After two years of input from key stakeholders, the state announced six managed care plans in April, but the Senate-passed budget calls for a re-do of the managed care procurement process, and stipulates managed care organizations based in Ohio be significantly considered.
LeeAnn Brooks, chemical dependency counselor for Health Recovery Services in Athens, is concerned about the impact on her patients.
“It’s going to make this whole managed care plan start all over,” Brooks contended. “And then that in turn is going to affect Southeast Ohio and Appalachia, and it’s going to take services away from people in the region as well as others in the state. That’s going to be a bigger setback, and it’s going to cost the state more money.”
It’s estimated more than $400 million in administrative costs would be wasted by stopping the procurement process.
Backers of the amendment claim there was not enough transparency in the bidding process for the $20 billion in contracts, and they argued Ohio companies should get special consideration.
This week, a budget conference committee will assemble. The final biennium budget is due June 30.
Brooks pointed out the Medicaid program is a crucial tool in helping those impacted by the opioid epidemic, many of whom don’t have any other type of insurance. She explained because addiction is a brain disease, it is important treatment not be interrupted.
“That’s planting a seed with people and getting them to understand that what they’re doing is really making their life unmanageable,” Brooks asserted. “With Medicaid, we can continue those treatment services in hopes of changing behaviors, in hopes of getting people into recovery.”
One of the current providers that did not make the list, Toledo-based Paramount Advantage, complained out-of-state companies were favored over those with headquarters in Ohio. The state countered the procurement process is competitive and included extensive public outreach.
Clipped from: https://www.clevescene.com/scene-and-heard/archives/2021/06/14/senate-budget-derails-ohios-medicaid-managed-care-process