Tag: State News

MM Curator summary

[MM Curator Summary]: More info on the recent CareSource win in MS and the partnership with TrueCare.

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.

JACKSON • The state Division of Medicaid will award a new contract for managing insurance benefits for Mississippi’s most vulnerable citizens to a not-for-profit backed by some in-state hospitals and two other private organizations.

The division said in a press release on Wednesday that it intends to award TrueCare, Magnolia Health and Molina Healthcare with the lucrative contracts for administering Medcaid’s managed care system, called MississippiCAN, and the Children’s Health Insurance Program.

Two state agencies investigated Magnolia Health, the Mississippi subsidiary of health giant Centene, over allegations tied to pharmacy benefit managers. 

TrueCare is a not-for-profit formed by some private hospitals and the Mississippi Hospital Association over their belief that in-state hospitals can provide better services to patients, which is different from a traditional managed care organization.

To manage the benefits, TrueCare partnered with CareSource Management Services, an Ohio-based managed care operation. CareSource will manage the day-to-day operations and TrueCare will provide “local expertise and oversight,” according to TrueCare’s proposal it submitted to the division.

“Our mission is to ensure Mississippians can easily access their benefits to live healthier lives, while prudently managing state resources,” the proposal reads.

The organizations who submitted applications to the Division of Medicaid are still technically under procurement rules that require them to be silent, meaning entities are limited in what they can publicly say.

Senate Public Health Chairman Hob Bryan told the Daily Journal he thinks that having a not-for-profit and traditional managed care organizations managing Medicaid benefits in the state at the same time will be a “great controlled experiment.”

“I think this is a great opportunity,” said Bryan, D-Amory. “The Hospital Association for years has said they can do a better job of providing these benefits. Well, here’s their chance to prove it.”

Mississippi’s Medicaid managed care system provides health insurance benefits for about 480,000 poor adults and children, disabled people, pregnant women, and others.

The Division of Medicaid pays managed care organizations a set rate per patient to administer those benefits.

The other two organizations who are set to receive contacts — Molina and Magnolia — are for-profit managed care entities who are also currently administering portions of the state’s Medicaid benefits.

Another surprising development from the division’s announcement was that United Healthcare, a managed care firm who was already administering part of the state’s Medicaid benefits, was not awarded any contract.

Groups have seven calendar days to protest the division’s decisions on who should receive contracts, but it’s unclear if any organizations who submitted proposals intend to file a protest petition.

After the protest period lapses, the contracts will go before the state’s procurement review board for approval.

The division’s decision comes at a time when traditional managed care organizations have come under scrutiny by some physicians, independent pharmacists and lawmakers.

Hospitals leaders and independent pharmacists have criticized managed care firms and PBMs for putting profits ahead of patient services. But managed care organizations largely contend that they’ve accomplished their goal of controlling the state’s fluctuating Medicaid costs.

State Auditor Shad White inked an agreement in April 2019 with Ridgeland-based law firm Liston and Deas to help investigate if Magnolia Health, the Mississippi subsidiary of health giant Centene, was over-inflating its bills to the state Medicaid division, as previously reported by the Daily Journal.

The investigation by the outside attorneys, White and Attorney General Lynn Fitch centered on one portion of the managed care system: pharmacy benefit managers.

These subcontractors, known as PBMs, serve as middlemen between insurance companies, drugmakers and pharmacies. They manage drug benefits, negotiate drug prices and reimburse pharmacists on behalf of companies.

Centene settled with the state in June 2021 for $55.5 million. The company did not admit any wrongdoing in the agreement, and the state said the company was providing quality health services.

The settlement, though, hasn’t stopped White’s office from continuing to examine the billing practices of PBMs. White’s office in March signed an agreement with data analytics firm Intelaform Services to collect and analyze a wide breadth of data involving PBMs that do business with the state.

The contract between White and Intelaform authorizes the private firm to investigate and analyze data generated by PBMs, pharmacy benefit administrators and managed care organizations that conduct business with state agencies — a wide scope of data.

The new contracts come at a time when the House and Senate Insurance Committees are set to convene a hearing on Aug. 29 to examine PMBs and the state’s insurance plan.

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Clipped from: https://www.djournal.com/news/state-news/division-of-medicaid-to-contract-with-nonprofit-backed-by-state-hospitals-to-administer-benefits/article_7c97c5a8-d1a0-5700-af98-5b9289428e0f.html

MM Curator summary

[MM Curator Summary]: D.C. MCO procurements are weird.

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.

A component of one of the largest health care providers in the D.C. region wants to continue providing Medicaid services to District residents but its leaders complain the company has been caught up in an administrative and bureaucratic process that threatens its ability to deliver for its patients.

Ieisha Gray serves as the chief operating officer for the CareFirst BlueCross BlueShield Community Health Plan District of Columbia, herein known as CareFirst. Gray said her company has performed well in serving District residents on Medicaid and wants that to continue.

“We have a demonstrated record serving Medicaid patients in D.C.,” Gray said. “We have the perspective that Medicaid patients should have the same level of health care quality that District government officials have access to.”

Medicaid serves as the federally-funded, locally-managed health care plan for those who count as low-income, disabled, under the age of 19, pregnant, some senior citizens and needy single parents. 

In the District, managed care organizations (MCOs) like CareFirst serve Medicaid patients who do not pay for their medical care. Those who qualify for the program range from an individual who earns up to $19,000 annually to a family of four with a combined income of no more than $37,000 a year.

Statistics reveal over 230,000 residents – 33% of the city’s population, utilize Medicaid. The multi-year contract MCOs operate under amounts to $3 billion collectively.

CareFirst’s Complaints about the Procurement Process

CareFirst leaders said the recent MCO procurement process “was deeply flawed and highly unusual” in documents obtained by the Informer.

“It was marred by the disqualification of three-out-of-four plans for unimportant minutia – whether the listed certified business enterprise (CBE) numbers were the new ones or old ones and for simple typos in the numbers of bona-fide CBEs,” the documents said. “The District’s choice of Medicaid MCO plans has serious implications for its ability to address chronic diseases that disproportionately afflict low-income District residents.”

According to CareFirst documents, the first Request for Proposals took place in November. In January, the District’s Office of Contract and Procurement (OCP) disqualified three of the MCOs, including CareFirst for what it termed “non-substantive” errors in their subcontracting plans. Two competing plans – MedStar Family Choice and Amerigroup – used old CBE numbers given to them by subcontractors which terminated them from consideration while CareFirst received disqualification from the process due to small typos in its subcontracting plan.

In the District by law, there must be three MCOs to move forward with granting Medicaid contracts. As a result, the process moved into February in which OCP opened up a second round for consideration because only one MCO, AmeriHealth, had been selected.

 Meanwhile, the three MCOs that received denial appealed the decision to the District’s Contract Appeals Board (CAB). In consideration, CAB upheld MedStar’s disqualification but overturned Amerigroup’s. CareFirst’s disqualification remained with CAB ruling that the contracting officer had the right not to give it a contract based on the typos of which the company labeled “minor” and “non-substantive.”

In its documents, CareFirst officials said, ‘what happened next defies logic.” It said Amerigroup “was put back in the original procurement, the one that began in November 2021.” The two remaining plans in the original procurement – AmeriHealth and Amerigroup – received contracts by the OCP by default. As a result, CareFirst and MedStar had to compete for the third MCO spot in February. 

CareFirst officials complained that the plans didn’t receive assessment based on “substantive items that matter.”

“For instance, the quality of each plan’s provider network, care coordination and case management tools, etc.,” the documents said. “In other words, the items that have real consequences for the overall quality of healthcare received by low-income District residents were seemingly less important than whether the CBE number listed for a subcontractor was up-to-date.”

Gray said in 2021, CareFirst achieved the first perfect score on all six National Committee on Quality Accreditation criteria in the history of the city’s Medicaid program. She said CareFirst lead other MCOs in 10-out-of-14 quality categories measured by the District. Additionally, in regards to children’s access to routine care, CareFirst received a 95% compared to 83% and 77% by the other two plans.

“We have the largest network of health care providers,” Gray said. “We can give Medicaid patients the care they need.”

Ambrose Lane, Jr., the chairman of the Health Alliance Network, has watched the District’s Medicaid process over the years. He spoke about the contract procurement system’s shortcomings.

“There are flaws in the procurement process and they need to be addressed in order for things to go forward,” Lane said. “Last year, Amerigroup was the odd man out and this year, it is CareFirst.” 

Lane said D.C. Mayor Muriel Bowser should submit the contracts to the D.C. Council for approval adding that contracts over a $1 million must be approved by the council. 

“The executive doesn’t have to wait for the ruling from the CAB,” he said. “I was told by a councilmember that she doesn’t have to wait on them. But by the way things look now, it looks like she will have to request an extension until 2023.”

Regarding CareFirst’s complaints about the contracting process, OCP’s communication team sent the Informer a statement noting the November and February solicitations. 

“Both solicitations have since closed,” the statement said. “In accordance with District requirements and to ensure the sustainability of the District’s managed care program, the District will contract with up to three MCOs so that Medicaid beneficiaries will have a choice of providers. There are three pending protests at the [CAB]. OCP will complete the award process once these protests are resolved.”

Clipped from: https://www.washingtoninformer.com/carefirst-questions-d-c-medicaid-contract-process/

MM Curator summary

[MM Curator Summary]: Average claims processing time is 12.8 days, but some providers still wait much longer.

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.

By Travis Fain, WRAL state government reporter

One year into a multibillion-dollar overhaul of North Carolina’s Medicaid program, providers complain that billing delays from insurance companies that manage claims are leaving patients without full treatment and the providers with financial problems.

Providers who’ve reached out to the state’s help line to complain describe the transition as a debacle. Some fear losing their businesses as late payments stretch into six figures.

“I’m losing sleep wondering if I am going to be able to make payroll,” Sharon Jordan, the chief executive of a Charlotte speech therapy company, said in an email to the state ombudsman charged with troubleshooting problems.

“I’m so tired,” Jordan wrote in a June email released through the state open records act. “I’m so depleted. I am tired of fighting. If this is what the state of North Carolina intends to happen with this change, then you’ve won.”

The state’s top Medicaid official and a spokesman for the five insurance companies that manage the plans acknowledge problems, and companies that pay late must pay penalties and interest. The department last week said it couldn’t immediately tally those amounts, which go to the providers.

But DHHS and the companies themselves say they’re generally pleased with how the program’s going, considering they’ve shifted more than 1.7 million people from a single, state-run Medicaid program to five new ones overseen by private insurers. This new managed Medicaid system has handled 17.2 million medical claims in a year, with 14 million paid and 3.2 million denied, according to DHHS. The average processing time is 12.8 days, the department said.

“Overall it’s going relatively well,” said Dave Richard, DHHS’ deputy secretary for Medicaid.

“I know that a couple of those providers that have gone through that process have really been hurt financially,” Richard said. “That’s unacceptable. We need to work through these quicker. We need to make sure that people are getting paid.”

‘Kids need these’

When the state laid out its Medicaid transformation plan, it created a help desk to help walk providers through a newly complex billing system. It also created an ombudsman to handle the most persistent problems.

That ombudsman received 439 calls or emails in June—the second highest monthly total since the program went online in June of 2021, according to DHHS numbers.

Transformation is meant to check escalating costs for the state’s Medicaid program, which provides health insurance to more than 2.8 million people, mostly children, senior citizens and people with disabilities. The program’s annual budget is slightly more than $18 billion, most of which is federal money.

In past years Medicaid spending ballooned unexpectedly, blowing holes in the annual state budget. That led the Republican-led General Assembly to pass transformation, which Gov. Roy Cooper’s administration implemented, picking five insurance companies to manage most claims.

Those insurers—United Healthcare, WellCare, Carolina Complete Health, AmeriHealth Caritas and Healthy Blue, which is part of Blue Cross and Blue Shield—get paid a per-person fee, and it’s up to them to keep health care costs beneath what they’re paid.

With that change came five new ways to bill insurance plans, plus a sixth one for Medicaid patients still in the state’s old program. Providers now dealing with multiple companies describe varying degrees of rigamarole, shifting rules and massive amounts of wasted time as they deal with some combination of the insurers.

Each company is doing different things, according to Jordan, the speech therapy CEO. One week they pay, the next week the same procedure is denied and, “it’s not as easy as picking up the phone,” she said.

“It’s just ridiculous,” said Emma Bentham, a Fayetteville audiologist who said she never had a problem getting hearing aids cleared for children until transformation.

“Kids need these,” Bentham said. “There have literally been children that have gone a whole year now without hearing aids.”

Some providers believe insurers are purposefully denying or delaying claims to save money. That was always a concern for critics of Medicaid transformation: That there’s a profit motive to deny coverage for some of the state’s most vulnerable people.

Peter Daniel, executive director of the North Carolina Association of Health Plans, said that’s not what’s happening. The industry group represents the insurance plans running Medicaid managed care in North Carolina.

Daniel said communication problems, exacerbated by having to hire and train call center workers during the pandemic, are to blame.

“This is a glitch in the system of escalating issues,” he said. “It is not the companies trying to slow-walk providers at all.”

The five insurers have contracts with the state totaling about $6 billion a year, and Richard said the state requires each insurer to spend at least 88% of that money on care. Asked whether the companies have a profit motive to deny claims, Richard said the state “will aggressively review … to make sure that’s not happening.”

Daniel acknowledged that some providers – many of them small businesses – have not been paid. He said the plans “are taking these situations very seriously,” and he predicted rapid improvement.

“You’ll see over the next few weeks a clearing of these flagged claims,” Daniel said in late July. “They’re genuinely trying to get down to what the communications issues are.”

Hospitals have had problems as well. Cynthia Charles, spokeswoman for the North Carolina Healthcare Association, called the bill process “complicated and cumbersome” with “a tremendous amount of administrative burdens put on hospitals.”

‘Very apologetic’

Several providers told WRAL News that they saw improvement when the state’s ombudsmen got involved in their case.

“It seemed to push things much faster,” said Jonathan Wilkins, a therapist in Troy.

But Wilkins said his dealings with two of the companies he’s billed was “a nightmare for me as a sole proprietor.”

“Doing my own billing and having to bill these insurance companies that have these clearing houses,” Wilkins said. “And I was getting no communication about whether or not I needed to do something different.”

Corey Peña, who owns Royal Orthotics in Concord, has been fighting insurers for a year. Things improved recently, Peña said, once he went to the media, reached out to state lawmakers and had conversations with Richard, the state’s head of Medicaid.

After that, Peña said United Healthcare and AmeriHealth Caritas both reached out to schedule meetings about his problems. Carolina Complete Health CEO Chris Paterson met with him at the end of July.

“He was very apologetic,” Peña said. “He said, ‘We’re going to make this right.'”

Peña’s company makes leg braces for children, and he said the companies that he bills for Medicaid want “a stack of paperwork” – far more than the state required. Payment delays got so bad that Peña said he was considering selling his house or declaring bankruptcy. In a July email to Sen.

Ralph Hise

, a leading proponent of transformation when the General Assembly passed it, Peña called the state’s insurance companies “criminal.”

Peña was more upbeat last week. He expected a $69,000 payment soon from Carolina Complete and he had meetings set with other companies. But he remained skeptical. “You hear promises for over a year, you don’t know what to believe,” Peña said.

“I’m still in war mode where I’ve won one battle,” he said. “And now I’ve got to go on to my next battle in this war until I’m done.”

Clipped from: https://www.wral.com/nc-medicaid-providers-say-they-re-owed-big-bucks-while-children-go-without-care/20403738/

MM Curator summary

[MM Curator Summary]: Rate cells for LTSS will go up; all others will go down. Maybe. Probably not.

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.

Starting in October, most Medicaid managed care plans are going to get paid less for providing health care services to the millions of people in Florida who rely on the safety net program for their care.

Medicaid managed medical assistance plans are likely to see a 4.5% rate reduction beginning in October. Managed dental plans are set to see an 8.7% reduction. Managed long-term care plans will likely see an 8.4% hike in reimbursement rates, Florida Medicaid Director Tom Wallace said. 

The rate reductions for managed medical assistance, dental and children’s medical services — slated for a 3.1% decrease in October — are being driven by health care utilization caused by the COVID-19 pandemic. The increase in the rates for managed long-term care plans is primarily attributable to the Legislature’s requirement that long-term care providers increase wages for workers.

“These are draft final rates so there is a potential they might change,” Wallace told members of the Social Services Estimating Conference, which includes economists from the Governor’s Office as well as the Legislature. Wallace said though that he doesn’t expect to see any significant changes between the draft rates and the final rates.

Managed care plans must be paid actuarially sound rates as federal law requires To that end, the Agency for Health Care Administration, which houses the Medicaid program, contracts with Milliman to help determine the rates.

Milliman principal and consulting actuary
Andrew Gaffner told economists it has been “one of the most challenging rate-setting environments” he’s been involved in during his 25-year career as an actuary. That’s due mainly to the uncertainty surrounding the public health emergency (PHE) and how long it will remain in effect.

Milliman’s estimates assume the PHE will expire no later than January 2023. 

The public health emergency brings w 6.2% increase in the amount of federal funds for the program, which reduces the amount of state tax dollars needed to keep it running. However, states are banned from removing people from the Medicaid program so long as the public health emergency remains in effect.

Florida has a Medicaid managed care mandate, which means most beneficiaries are enrolled in managed care plans that have contracts with the state. 

State data show that the COVID-19 pandemic and the subsequent PHE have caused enrollment in Florida’s Medicaid program to balloon to more than 5.1 million people by the end of June, Most beneficiaries are enrolled in managed medical care plans.

Economists now predict that enrollment will reach 5.3 million by June 2023.

While enrollment in the Medicaid program, and managed care plans, is at an all-time high due to the PHE, utilization rates have dropped. Gaffner said those enrolled in the program due to the PHE restrictions don’t take advantage of the benefits the way traditional Medicaid enrollees do.

So, while enrollment is up, he said, utilization rates are down, which is the driving factor behind the rate reductions.

“The sooner it ends,” Gaffner said of the public health emergency, “the more of a rate increase we’ll likely have.”

The PHE is currently expected to expire in October. But due to federal rules, the state will continue to receive additional funds, and keep people on the program, through Dec. 31.

However, POLITICO reported that the administration of President Joe Biden is planning to extend the PHE beyond October. The administration has said it would give states 60 days’ advance notice before allowing the PHE to expire. If it sticks to the commitment, the administration must make an announcement by Aug. 15.

If the PHE expires, Florida will continue to receive additional funding, and be required to maintain enrollees, through March 2023. That’s three months longer than what lawmakers anticipated when crafting the state Fiscal Year 2022-23 budget.

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Clipped from: https://floridapolitics.com/archives/545839-medicaid-managed-medical-dental-and-childrens-plans-targeted-for-october-rate-reductions/

MM Curator summary

[MM Curator Summary]: The state AG says making states responsible for whether plans (or states) pay Medicaid providers would set a bad precedent.

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.

Saying a federal appeals court mistakenly created a “watershed moment” that could cost taxpayers hundreds of millions of dollars, Illinois Attorney General Kwame Raoul sides with insurance titans that administer healthcare reimbursements

Illinois Attorney General Kwame Raoul greets supporters on Primary Day at Manny’s Deli on June 28, 2022 in Chicago, Illinois. (Jim Vondruska/Getty Images)

State health officials are siding with large insurance companies to block a federal court decision supporting claims the state government is neglecting its responsibility to oversee billions of dollars spent on health care for the poor.

In an Aug. 2, 116-page petition filed with the U.S. Court of Appeals for the 7th Circuit, Illinois Department of Healthcare and Family Services Director Theresa Eagleson said the court made a mistake that could end up costing taxpayers hundreds of billions of dollars.

The filing asks the entire Court of Appeals to reconsider the July 5 opinion rendered by a three-judge panel. The opinion rejected lower court rulings siding with the state and reinstated a lawsuit against the state filed by a South Side safety-net hospital.

At issue is the state’s privatization of Medicaid billing procedures, which since 2018 has given authority over reimbursement decisions to several major insurance companies under contract with the state.

Since then, those insurance companies — including such corporate titans as Blue Cross Blue Shield, Centene Corp., CVS Health Corp. and Molina Healthcare Inc. — have collected hundreds of millions in profits while delaying, denying and reducing reimbursements to the frontline doctors, hospitals and caregivers, according to a Better Government Association investigation last year called “Milking Medicaid.”

The three-judge appellate panel cited the BGA probe last month when it ruled in favor of Saint Anthony Hospital, which claims the new system left it unable to pay its bills or to adequately care for its patients.

Illinois Department of Healthcare and Family Services Director Theresa Eagleson.

“To sum up, Saint Anthony has alleged a viable right … to have HFS act to try to ensure timely payments from MCOs, and that right is enforceable … against HFS Director Eagleson in her official capacity.”

But Illinois Attorney General Kwame Raoul, who filed the petition on behalf of Eagleson, alleged the ruling was a mistake that creates a “watershed moment” for America’s Medicaid program.

“It presents a question of first impression for federal circuit courts with immense practical importance for Medicaid managed-care programs nationwide, involving dozens of States and hundreds of billions of dollars in spending each year,” Raoul wrote.

“Beyond just establishing precedent in this circuit, this court’s interpretation … will likely be cited as persuasive authority in future cases elsewhere,” the filing says. “And on a question of such extraordinary significance, it is crucial to get the answer right.”

The state’s position appears to counter a recent legislative hearing conducted to address the concerns of health care providers, now required to arbitrate disputes against private insurance companies on every delayed or denied reimbursement.

Chicago Democratic state Rep. Mary Flowers said the system is largely bereft of government oversight.

“Doctors went through the storms of the pandemic without getting paid,” Flowers said at the hearing. “It’s appalling.”

Seventeen state lawmakers attended that joint hearing, in which three safety-net medical providers testified the insurers are boosting their profits by deploying bureaucratic dodges and opaque billing error codes to skirt the federal rule, make partial payments, pay years late or deny claims without explanation.

“We have struggled mightily,” testified Tim Egan, president and CEO of Roseland Community Hospital on the South Side.

Ben Winick, Eagleson’s chief of staff, testified HFS is working with the insurers to put these billing problems behind them and make sure the safety-net providers get paid on time and in full. “We’ve worked diligently to resolve provider disputes. We take those extremely seriously. We’ve made a lot of progress,” Winick said.

“I recognize that our current situation is not perfect, but progress is being made,” testified Samantha Olds Frey, CEO of the insurers’ trade association. Olds Frey declined to comment on the pending Saint Anthony’s litigation.

Earlier this year, Illinois state Sen. Celina Villanueva introduced a bill that would provide more oversight, but Senate Bill 3916 was referred to the Senate Assignments Committee and hasn’t moved since then, state records show.

Before becoming Illinois’ attorney general, Raoul was a state senator for 14 years, in which he worked to expand access to Medicaid.

“Ensuring that every Illinois resident has access to affordable health care is particularly important for Kwame,” according to his campaign website. “Kwame is also grounded by the work of his father, a community physician who spent 30 years on Chicago’s South Side caring for patients regardless of their ability to pay.

“Watching his father’s dedication to providing care to all patients instilled in him that health care is a right for all of us and not a privilege for the few.”

His office did not immediately respond to a request for comment on Wednesday.

The Medicaid insurers’ annual reports for last year show they earned substantial profits from their Illinois contracts. Three of the four state Medicaid contractors — subsidiaries of Centene, CVS and Molina — reported combined profits of $433 million for 2021, and that came after paying hundreds of millions of dollars in administrative fees and dividends to their national parent corporations. Comparable figures were not available for the fourth contractor, an affiliate of Blue Cross Blue Shield.

Petitions like the ones Raoul and the insurers filed – for an “en banc” rehearing before the entire Appellate Court – are rarely granted, according to the Seventh Circuit’s guide for lawyers, the Practioner’s Handbook for Appeals. Saint Anthony’s responses are due to be filed by the end of this month.

HFS Media Relations Officer Jamie Munks said the agency would not comment about ongoing legal proceedings. 

“It should be noted that the hearings to date have only been to determine whether Saint Anthony can move its case forward in legal proceedings,” Munks said. “No judgment has been made about whether their claims have any merit.”

Clipped from: https://www.bettergov.org/news/state-filing-on-medicaid-delays-asks-court-to-reconsider/

MM Curator summary

[MM Curator Summary]: Centene joins Molina and TrueCare/CareSource in the winners’ circle.

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.

ST. LOUIS, Aug. 10, 2022 /PRNewswire/ — Centene Corporation (NYSE: CNC) announced today its Mississippi subsidiary, Magnolia Health Plan (Magnolia), has been awarded the Mississippi Division of Medicaid (DOM) contract. Under the new contract, Magnolia will continue serving the state’s Coordinated Care Organization Program, which will consist of the Mississippi Coordinated Access Network (MSCAN) and the Mississippi Children’s Health Insurance Program (CHIP). The new contract term is four (4) years and includes the option for two, 1-year renewals.

“We are honored to have the opportunity to continue serving our state partners to help build a healthier Mississippi,” said Brent Layton, Centene’s President and Chief Operating Officer. “We look forward to continuing our long-standing partnerships with our network of local providers and community partners, to deliver member-focused care and improve health outcomes while strengthening communities throughout Mississippi.”

Nearly 1 in 4 Mississippians’ healthcare is covered through the state’s Medicaid managed care program, which provides access to physical health, behavioral health, pharmacy, hospital, and other services. Today, Magnolia serves more than 150,000 Medicaid enrollees and partners with 30,850 healthcare providers statewide.

“For more than a decade, Magnolia has been committed to increasing access to high-quality healthcare for Mississippians,” said Aaron Sisk, Magnolia President and CEO. “We believe our focus on the wellness of the whole person, along with our local presence in Mississippi, allows Magnolia to uniquely address the health needs of our communities.”

Magnolia has served the Medicaid population in partnership with DOM since 2011. The organization also focuses on under-insured and uninsured individuals through its federal insurance marketplace plan, Ambetter. Additionally, Magnolia provides insurance for the Medicare population through its Medicare Advantage plan, WellCare.

About Centene Corporation
Centene Corporation, a Fortune 500 company, is a leading healthcare enterprise that is committed to helping people live healthier lives. The Company takes a local approach – with local brands and local teams – to provide fully integrated, high-quality, and cost-effective services to government-sponsored and commercial healthcare programs, focusing on under-insured and uninsured individuals. Centene offers affordable and high-quality products to nearly 1 in 15 individuals across the nation, including Medicaid and Medicare members (including Medicare Prescription Drug Plans) as well as individuals and families served by the Health Insurance Marketplace, the TRICARE program, and individuals in correctional facilities. The Company also serves several international markets, and contracts with other healthcare and commercial organizations to provide a variety of specialty services focused on treating the whole person. Centene focuses on long-term growth and value creation as well as the development of its people, systems, and capabilities so that it can better serve its members, providers, local communities, and government partners.

Centene uses its investor relations website to publish important information about the Company, including information that may be deemed material to investors. Financial and other information about Centene is routinely posted and is accessible on Centene’s investor relations website, https://investors.centene.com/.

Clipped from: https://investors.centene.com/news-events/press-releases/detail/1040/centene-subsidiary-selected-to-continue-serving