Tag: State News

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Georgia in line to recover $500 million in Medicaid overpayments

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GA is completing its effort to recover managed care funds not spent during the pandemic.

 
 

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.

 
 

 
 

Georgia is in line to recover $500 million from state Medicaid insurers for overpayments in 2020 and 2021, according to an insurance industry official who represents the companies.

Special Photo: Georgia Health News

ATLANTA — Georgia is in line to recover $500 million from state Medicaid insurers for overpayments in 2020 and 2021, according to an insurance industry official who represents the companies.

The half-billion-dollar payout will come from two separate Medicaid recoveries, Jesse Weathington, the executive director of the Georgia Quality Healthcare Association, said. Due to the federal role in financing Medicaid, much of the returned money would likely go to the U.S. government.

The insurers were told the reduction was due to many Medicaid patients skipping medical care during the COVID-19 pandemic, along with other adjustments, Weathington said.

“It was surprising in terms of timing and the amount,” Weathington said. He added that the three Medicaid insurers were not given detailed breakdowns of how the state actuary arrived at the numbers.

The Georgia Medicaid insurers – Peach State, Amerigroup and CareSource – are paid a per-member, per-month rate to care for Medicaid members. These insurers continued to receive those payments from Medicaid while there was a drop-off in patient visits.

The repayments are known as clawbacks: When an organization believes it has overpaid for services, it takes steps to get the money back.

“Clawbacks mean people did not get health care,” Laura Colbert, executive director of Georgians for a Healthy Future, a consumer advocacy group, said. “Essentially, people may have missed services they needed last year. That’s no fault of the [Medicaid insurers] because we saw that happen across the board, regardless of the type of insurance. The state still has a right to address that based on their contract.”

The Department of Community Health, which runs Medicaid in the state, did not respond to GHN’s requests for comment.

The $202 million retrospective rate adjustment for 2020 is now awaiting approval from the federal Centers for Medicare & Medicaid Services, Weathington said. Another $300 million mid-year adjustment for 2021 is currently under negotiation, he added.

Medicaid, jointly financed by the federal government and individual state governments, covers low-income and disabled residents. Georgia pays the Medicaid insurers more than $4 billion each year to provide care to low-income children and other vulnerable populations. The state covers about one-third of those costs, with the feds funding the rest.

It’s unclear how much of the recovered funds will go to the feds and how much to Georgia’s coffers. But if it’s split by the normal funding formula, the state would gain more than $165 million.

The projected $500 million recovery comes after Medicaid insurers posted big profits during 2020, according to the Center for Children and Families at Georgetown University.

Before the pandemic, many states had measures in place to limit the profits that state Medicaid insurers could make on their contracts and ensure taxpayer dollars went to patient care. Georgia was not one of those states, according to the Center on Budget and Policy Priorities.

Other states have adopted or bolstered measures to recover taxpayer dollars that went to Medicaid programs while patients stayed home during the pandemic. There are different ways states can do this.

For example, Virginia directed state Medicaid insurers to increase payments to medical providers.

 
 

Two of the Georgia insurers – Peach State and Amerigroup – are owned by publicly traded, for-profit corporations, Centene and Anthem, respectively. Centene last year acquired WellCare, another Medicaid insurer, and closed down its WellCare Medicaid operations in May.

A third Medicaid insurer, CareSource, is a nonprofit company based in Ohio.

Clipped from: https://www.news-daily.com/news/georgia-in-line-to-recover-500-million-in-medicaid-overpayments/article_a660e200-f871-5353-8685-507aebfef43b.html

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NC calls Medicaid payment delays unacceptable

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Some speech therapists are reporting delayed payments, but the overall claims denial rate is lower than expected.

 
 

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.

 
 

 
 

CHARLOTTE, N.C. — Therapists who work with some of North Carolina’s most vulnerable children are growing increasingly frustrated with the state’s transition to Medicaid Managed Care.

‘It’s not acceptable’

Small healthcare business owners from Charlotte, Concord and Salisbury told WCNC Charlotte the private companies that recently took over the state’s Medicaid program continue to overburden their practices with paperwork and delay critical payments.

In the face of their anger, a top state official promised action.

“If I was the organization that wasn’t getting paid, I would feel exactly the same way,” North Carolina Medicaid Deputy Secretary Dave Richard said.

While Richard said the transition to managed care has gone relatively smoothly overall, he told WCNC Charlotte technical issues with provider coding in the claims process led to higher than normal denials in the first weeks of the program.

“It’s not acceptable,” Richard said of the delays in some businesses getting reimbursed. “We’re fixing it.”

At the beginning of August, the state reported a 12% denial rate.

“The number that we received actually was less than we would have anticipated with this transition,” he said.

‘Our patients will definitely pay the price’

Speech-language pathologist Tara Puma said her Salisbury in-home therapy business has yet to receive more than $5,000 in payments for services already provided.

“I haven’t been paid at all from two of the managed care organizations,” Puma said. “There hasn’t been clear and consistent guidance. They definitely seem ill-prepared.”

Puma said she is waiting on more than 70 claims.

“With the managed care companies that are not paying, I am looking at putting those children on hold for services until we can get reimbursed for them,” Puma said. 

After years of preparation, North Carolina officially switched to Managed Care on July 1. In doing so, the state handed over control of its Medicaid program to five private companies.

Medicaid covers nearly 1.6 million low-income adults, children, pregnant women, seniors and people with disabilities throughout North Carolina.

“It is very frustrating and our patients will definitely pay the price because there are some practices that are going under or are putting some kids on hold for services,” Concord business owner and speech-language pathologist Stephanie McGowan Fish said. “Every day there’s something new that’s coming up.”

She said her practice is waiting on $35,000 in payments.

“Our patience is kind of wearing thin at this point,” she said. “We need some hardcore problem solving because we’re just not getting that. We’re just getting lip service at this point.”

‘I can’t think of another business where you don’t get paid for an entire month’ 

Richard said not only are the state and private companies committed to solving the problems, but they’re also both willing to cover critically hurting businesses’ costs, in the form of advances, while they wait.

“If we have providers in a place to where they can’t get paid, health plans can’t do it, we’re prepared to be that backstop,” he said, citing available emergency hardship advances. “If they’re at that place to where they believe that they can’t take patients because they’re not getting paid, we want to know, because that’s not something that’s acceptable to us.”

Richard said the state has received 17 requests for hardship payments.

He also said the state has taken “way too long” reprogramming its claims system related to last-minute legislation that requires providers to bill Medicaid directly for the Infant and Toddler Program rather than the new health plans. He said the needed changes will be in place by Aug. 16.

Charlotte speech-language pathologist Rebecca Rowe said she’s owed more than $9,000 in reimbursements.

“At this point, we do not feel taken care of,” Rowe said. “I can’t think of another business where you don’t get paid for an entire month, and that’s the problem.”

Richard said the state is committed to its transition promise that patients would continue to be seen and providers would be paid.

“I appreciate you raising these questions for us,” he told WCNC Charlotte. “These are really important things.”

The executive director of the North Carolina Association of Health Plans declined an on-camera interview, but in a statement, called any single incident or issue “unfortunate.”

“Since joining the Association of Health Plans as the Executive Director on July, I’ve been impressed by what I’ve witnessed,” Peter Daniel said. “While any single incident or issue is unfortunate, there’s an incredible amount of communication and coordination among regulators, health plans, providers and other stakeholders- all of whom share a commitment to make this transition work for the more than 1.6 million beneficiaries who deserve exceptional, integrated care. And while there is work still to do, we are already seeing measurable success in the transition.”

 
 

Clipped from: https://www.wcnc.com/article/money/nc-medicaid-payment-delays-unacceptable/275-b6963a76-c05f-4aa1-8465-c6ad0d5f9a39

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NCDHHS Announces Medicaid Managed Care Regional Behavioral Health I/DD Tailored Plans- Bladen County Included

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The winners were announced last week, and will be live Sept 1.

 
 

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.

 
 

 
 

The North Carolina Department of Health and Human Services announced the selection of seven organizations to serve as Behavioral Health and Intellectual/Developmental Disability Tailored Plans (Behavioral Health I/DD Tailored Plans). Individuals who need certain services to address a serious mental illness, serious emotional disturbance, severe substance use disorder, intellectual/developmental disability or traumatic brain injury may be eligible to enroll in a Behavioral Health I/DD Tailored Plan.

Following a competitive selection process, the following organizations were awarded a contract to serve as regional Behavioral Health I/DD Tailored Plans:

• Alliance Health

• Eastpointe

• Partners Health Management

• Sandhills Center

• Trillium Health Resources

• Vaya Health

• Cardinal Innovations Healthcare*

*While Cardinal Innovation Healthcare was awarded a contract, it is anticipated they will not operate a Behavioral Health I/DD Tailored Plan at launch due to the consolidation with Vaya Health. 

Behavioral Health I/DD Tailored Plans will provide integrated physical health, behavioral health, long-term care, pharmacy services and will address unmet health-related resource needs for qualifying North Carolinians under one plan. These plans will provide the same services as NC Medicaid Standard Plans with additional specialized services to serve individuals with significant behavioral health conditions, including those utilizing 1915(c) Home and Community-Based Services waivers and those utilizing State Funded Services. 

“NCDHHS looks forward to working with the awardees to make this innovative design a reality for the thousands of North Carolinians who will benefit from a whole person centered, well-coordinated system of care,” said NCDHHS Secretary Mandy K. Cohen, M.D. “Today moves us closer to that goal as we begin to implement this important program design.” 

At launch, Behavioral Health I/DD Tailored Plans will operate regionally, offering robust care management to approximately 200,000 individuals estimated to enroll. An additional unique feature of Behavioral Health I/DD Tailored Plans is the combination of Medicaid and state funding to support enrolled populations. 

The contract award covers counties in each catchment area as of July 26, 2021, as well as realignments approved by Secretary Cohen effective Sept. 1, 2021. Given additional county requests for disengagement, NCDHHS anticipates county alignments for Behavioral Health I/DD Tailored Plans will be significantly different at launch. County realignment and disengagement requests must go through the process identified in law and rule which ultimately require DHHS Secretary’s approval. The list below indicates the anticipated county alignments at go-live. 

“We will work closely with LME/MCO’s to assure a smooth transition to Behavioral Health I/DD Tailored Plans while they continue to oversee the crucial services currently provided through the LME/MCO’s” said Deputy Secretary of NC Medicaid, Dave Richard. 

Only entities operating as LME/MCOs were eligible to apply to become Behavioral Health I/DD Tailored Plans. The first Behavioral Health I/DD Tailored Plans contract term will last four years. The Department has the authority to award no more than seven and no fewer than five regional Behavioral Health I/DD Tailored Plan contracts and may not award any statewide contracts.

Under Medicaid Managed Care, Standard Plans and the Eastern Band of Cherokee Indians (EBCI) Tribal Option launched on July 1, 2021, followed by Tailored Plans on July 1, 2022. 

For information specific to Behavioral Health and I/DD Tailored Plans, please visit the Behavioral Health I/DD Tailored Plans page. 

More information about the transition to NC Medicaid Managed Care can be found on the Medicaid website at medicaid.ncdhhs.gov/transformation.

 
 

Projected County Alignments at Tailored Plan Launch for July 1, 2022

This list reflects projected county assignments based on disengagements requested or approved. County realignment and disengagement requests must go through the process identified in law and rule which ultimately require approval by the NCDHHS Secretary.

Alliance Health: Cumberland, Durham, Johnston, Orange, Mecklenburg and Wake. 

Eastpointe: Duplin, Edgecombe, Greene, Lenoir, Robeson, Sampson, Scotland, Wayne and Wilson.

Partners Health Management: Burke, Cabarrus, Catawba, Cleveland, Davie, Forsyth, Gaston, Iredell, Lincoln, Rutherford, Stanly, Surry, Union and Yadkin.

Sandhills Center: Anson, Davidson, Guilford, Harnett, Hoke, Lee, Montgomery, Moore, Randolph, Richmond and Rockingham. 

Trillium Health Resources: Bladen, Brunswick, Carteret, Columbus, Nash, New Hanover, Onslow, Pender, Beaufort, Bertie, Camden, Chowan, Craven, Currituck, Dare, Gates, Hertford, Hyde, Jones, Martin, Northampton, Pamlico, Pasquotank, Perquimans, Pitt, Tyrrell and Washington.

Vaya Health: Alamance, Alexander, Alleghany, Ashe, Avery, Buncombe, Caldwell, Caswell, Cherokee, Clay, Franklin, Graham, Granville, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Person, Polk, Rowan, Swain, Transylvania, Vance, Watauga, Wilkes and Yancey.

Pending: Chatham, Halifax, Stokes and Warren. 

 
 

Clipped from: https://bladenonline.com/ncdhhs-announces-medicaid-managed-care-regional-behavioral-health-i-dd-tailored-plans-bladen-county-included/

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MS may be paying out fraudulent Medicaid benefits

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A new audit in MS shows members are getting enrolled even when they are ineligible due to higher incomes.

 
 

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.

 
 

As part of its Single Audit Report for the 2020 fiscal year, the Mississippi auditor’s office sampled 180 Medicaid beneficiaries and found that nine of them were ineligible due to the high income reported on their state tax returns.

On average, those nine reported income levels $10,727 above the threshold for Medicaid enrollment.

In addition to the nine individuals flagged in the sample, two people who own multi-million dollar homes and declared high incomes on their tax returns, despite receiving Medicaid benefits, had already been flagged as potential fraud cases to investigate. 

Under current state law, the Mississippi Division of Medicaid does not have the legal authority to obtain state income tax returns to compare them with the income declared by a person applying for Medicaid benefits. State Auditor Shad White is now calling on Gov. Tate Reeves and the Legislature to grant this authority so that potential fraud can be prevented on the front end. 

“I stand ready to work with Medicaid’s leadership to argue to lawmakers that they should have this tool in their toolbox,” White said in a press release. “It could stop ineligible applicants from being put on the program in the first place. We know this tool would be useful because Medicaid’s internal policies state they should ask an applicant for their return, but without the authority to get the return and a requirement to use it, the state is potentially handing out millions to ineligible people.”

In a statement, the Mississippi Division of Medicaid (DOM) said it does not agree that the use of state tax returns would help root out fraud, as the tax information used by the auditor’s office in this case is from more than a year before the person applied for Medicaid. DOM is required to base eligibility on current income and noted that “financial information that far out of date may not accurately reflect the current circumstances of applicants.”

In June 2019, the most recent month for which figures are available, 673,247 Mississippians were enrolled in Medicaid.

Clipped from: https://mississippitoday.org/2021/08/02/mississippi-fraudulent-medicaid-benefits/

  

 

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Controller finds overpayments, money spent on yoga in Philly’s administration of Medicaid funding

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The latest audit of Philadelphia Medicaid payments shows egregious issues that the mayor is dismissing.

 
 

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.

 
 

The controller’s report flagged overpayments, plus money spent on fitness and yoga instructors.

 
 

City Controller Rebecca Rhynhart speaking at a news conference last year.Read moreMONICA HERNDON / Staff Photographer

The Philadelphia agencies overseeing distribution of $1 billion in Medicaid funding for mental health and drug and alcohol services have overpaid providers and lacked proper documentation and oversight, according to an audit by the city controller released Thursday.

Controller Rebecca Rhynhart‘s office examined the administration of Medicaid funds in fiscal year 2017 and found $10 million in payments for services that were not actually provided, $4 million in temporary advances to providers that were not paid back, and money spent on employee perks such as fitness and yoga instructors.

“It is so important that this [money] is used well so that the people of our city can deal with addiction issues and trauma issues,” Rhynhart said in an interview.

The city’s Department of Behavioral Health and Intellectual disAbility Services (DBHIDS) distributes about $1 billion annually through the HealthChoices program and contracts with Community Behavioral Health (CBH), a nonprofit that acts as a quasi-governmental agency and administers funds to health-care providers. Money for HealthChoices comes from state Medicaid funding and does not include money from the city’s coffers. But Philadelphia, like other counties in Pennsylvania, is responsible for distributing and administering the Medicaid funding.

Mayor Jim Kenney, who often trades barbs with Rhynhart over her audits and reports, criticized the audit in a statement Thursday and said the agencies’ work has “established Philadelphia as an internationally recognized model for managed care.”

“There is little value to the public in a single audit looking at data that is nearly five years old – especially when CBH has successfully completed multiple rigorous accreditation and oversight reviews from national and state experts since that time,” Kenney said.

The agencies said in a news release that much of the “narrow set of recommendations” had already been implemented through changes in policies and leadership since 2017.

Rhynhart, however, said she still recommends that Community Behavioral Health implement stronger internal controls to monitor health-care providers and compliance with city policies.

Community Behavioral Health runs a recovery center program through which 13 different providers offer services to Medicaid patients in Philadelphia. The audit found that the providers were paid $33 million in fiscal year 2017 based on estimated services but did not reach full capacity and therefore were overpaid by $10.4 million.

Rhynhart’s report asserted that while auditors reviewed only one year of payments, “it is likely that CBH has paid providers millions of dollars annually for services not rendered to actual patients since the program’s inception.”

» READ MORE: Lawmakers renew call for stronger addiction treatment oversight as two Pa. providers charged

DBHIDS acknowledged in its response that recovery center providers had been receiving flat-funding while their numbers of patients decreased. The department said that issue was fixed in 2018 with a new payment system.

The controller’s office found instances of Community Behavioral Health giving temporary advances to providers, for which two providers defaulted on about $4 million in repayments during fiscal year 2017.

The audit also found that the city reimbursed Community Behavioral Health for more than $200,000 in “questionable” operating costs. That amount included $149,000 to celebrate the organization’s 20th anniversary with a day off for employees, buffet meals costing $11,000, promotional gifts, and a photo booth, as well as $54,000 for fitness and health programs for employees that included in-house massages, yoga, personal training sessions, healthy snacks, and FitBits.

The audit said that the city’s contract with Community Behavioral Health does not define ineligible costs, and the city does not review submitted expenses to determine whether they are appropriate. Rhynhart recommended improving oversight and implementing a formal review process.

The city’s response maintained that the 20th anniversary and employee wellness costs “are well within the purview of reasonable administrative expenses of a nonprofit organization.”

Rhynhart disagreed in a letter to DBHIDS Commissioner Jill Bowen. “I would like to emphasize that they are not necessary for the administration of the HealthChoices Program and come at the expense of Philadelphians in need of the essential services CBH provides,” she wrote.

While issues with overpayments or eligible reimbursements for an anniversary celebration do not affect the city’s operating budget, the Medicaid programs are funded with federal taxpayer money. And Rhynhart said that inappropriate spending uses up money that could be spent on helping needy Philadelphians with mental health and addiction.

“There’s this multitiered structure that exists, but despite that structure there really is a lack of oversight and accountability in many of our findings,” Rhynhart said.

Bowen said in a statement Thursday that the city “will continue to evolve and improve our services.”

The controller’s office also found issues with documentation, based on sampling 284 transactions and finding 149 instances of noncompliance with the documentation that health-care providers must give to Community Behavioral Health.

“That sounds very technical,” she said, “but it’s also the basic requirement and building blocks for services.”

 
 

Clipped from: https://www.inquirer.com/news/controller-rhynhart-medicaid-philadelphia-behavioral-health-20210729.html

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Virginia launches new behavioral health services for Medicaid members

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Virginia now covers three news services to try and help members avoid inpatient stays for mental health.

 
 

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.

 
 

 
 

RICHMOND, Va. (WAVY)– New state-funded behavioral health services will give Medicaid members in Virginia greater access to community-based care.

The new services, which began on July 1, will give Medicaid members alternatives to inpatient hospitalizations and offer supports for those discharged from an inpatient facility to reduce readmissions.

The services were developed through a collaboration between the Department of Behavioral Health and Developmental Services (DBHDS) and the Department of Medical Assistance Services (DMAS) with support from hundreds of stakeholders.

The services covered by Medicaid will include:

  • Assertive Community Treatment (ACT): Adults with serious mental illness receive care through a single team that works closely together to support the individual and is available 24/7.
  • Mental health partial hospitalization program: Adults and youth receive intensive services during daytime hours for five or six days per week while continuing to live in their homes.
  • Mental health intensive outpatient program: Adults and youth receive short-term, focused therapy and counseling both individually and with members of their support system two to three times weekly.

Virginia Medicaid members interested in the new services should contact their managed care organization or their behavioral health provider for more information.

An additional set of six new services will launch in December 2021.

Clipped from: https://www.wavy.com/news/virginia/richmond/virginia-launches-new-behavioral-health-services-for-medicaid-members/

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Massachusetts Scores 10% Medicaid Rate Hike Through American Rescue Plan Act Funding

 
 

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DME providers will be getting some of the 10% ARP money that MA has requested from CMS.

 
 

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.

 
 

 
 

BOSTON (July 22, 2021)—The MassHealth Medicaid program is implementing a 10% rate increase for durable medical equipment (DME) claims with dates of service effective July 1, 2021. The broad-based relief applies a 10% increase for all DME and augmentative and alternative communications codes and a 50% increase for labor code K0739, which covers repair or nonroutine service for DME other than oxygen equipment requiring a skilled technician.

“This is a big win when we needed it most,” said Jason Morin, president and CEO of the Home Medical Equipment and Services Association of New England (HOMES). “Between the pandemic impacts and the recent respiratory recall, providers are reeling and struggling to find ways to continue to absorb these rising costs. This action provides much-needed direct relief to the providers of Massachusetts and also shows us that the state’s Medicaid leadership is listening.”

In June, HOMES requested that DME suppliers receive a share of the health care focused relief funds granted to Massachusetts through the American Rescue Plan Act. This request, coupled with HOMES’ long-term efforts to build strong relationships with MassHealth leaders and other healthcare officials, gives suppliers serving Medicaid beneficiaries in the state a better footing to deal with higher product and operational costs related to the pandemic.

“It took a long time to develop, but we currently have an excellent relationship with the state Medicaid program. As a result, they have not only come to understand the value that our industry brings to their beneficiaries but also became provider advocates on a number of issues,” added Morin. “I also can’t overstate how instrumental Laura Williard, David Chandler, and the AAHomecare team have been in helping us to develop materials and resources and provide a national perspective in many of our meetings.”

AAHomecare has worked closely with state and regional association leaders to develop sample letters to request that DME suppliers receive a share of the $195 billion allocated to states to mitigate the fiscal effects of the COVID-19 pandemic on health care providers as well as a temporary 10% increase in federal matching funds for home and community-based services (HCBS). We will share more details on these efforts in an upcoming edition of Payer Relations in Focus.

“DME suppliers deserve a share of this support, and we’re committed to helping state leaders make the strongest possible case for being included in state-directed relief,” said Laura Williard, AAHomecare vice president of payer relations. “Now that the first state has explicitly approved our industry to share in this relief, we have an opportunity to let Medicaid officials in other states know about the precedent Massachusetts has set.”

Read the Massachusetts HHS announcement here.

Clipped from: https://www.homecaremag.com/news/massachusetts-scores-10-medicaid-rate-hike-through-american-rescue-plan-act-funding

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Kentucky Medicaid recipients get a $100 gift card with in-home vaccinations

 
 

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KY MCOs are increasing efforts to increase the low vax rate among Medicaid members.

 
 

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 Kentucky managed care program is using $100 gift cards to entice Medicaid recipients into getting the COVID-19 vaccine. WellCare Kentucky is providing the in-home shots in an effort to stem the spread of the coronavirus.

“We’re here to help those who want to be protected from COVID-19. We’ve gone community-by-community, neighborhood-by-neighborhood, and now we’re going door-to-door,”  WellCare Kentucky Chief Medical Officer Sandra Guerra, M.D., said. “Meeting our members where they are to ensure they have the care and services they need to get and stay healthy is critical to our mission and an integral part of our efforts to make vaccines available to anyone who wants one.”

Roughly 44% of Kentucky residents have been fully vaccinated so far — well below the national rate of 49%. In some rural parts of Kentucky the vaccination rate is below 25%. COVID-19 cases have been spiking in Kentucky over the past month. At the end of June, the state had a seven-day moving average of 162 cases. Last Friday, that number shot up to more than 600 cases.

Only WellCare members who opt in and agree to participate will be able to schedule an in-home appointment and receive a gift card. The program is available July through August.

 
 

Clipped from: https://www.mcknightsseniorliving.com/home/news/home-care-daily-news/kentucky-medicaid-recipients-get-a-100-gift-card-with-in-home-vaccinations/

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Ohioans on Medicaid Will Get $100 if They Get Their First COVID Vaccine by Sept. 15

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They tried $50 first but that didn’t increase vax rates very much.

 
 

 
 

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.

 
 

While 45% of Ohioans had received their first shot by May, the number was about half for Medicaid recipients.

 
 

 
 

While 45% of Ohioans had received their first shot by May, the number was about half for Medicaid recipients.Photo: Maryland National Guard/FlickrCC
 

Ohio Medicaid recipients who get their first COVID vaccine shot between now and Sept. 15 will receive a $100 gift card, the state’s managed care organization announced this week.

It previously had been offering $50 to those who received their first dose by Aug. 15, but the timeline was extended and the reward boosted in an effort to get shots into low-income Ohioans.

While 45% of Ohioans had received their first shot by May, the number was about half for Medicaid recipients. Studies have shown hourly workers have been left behind in the state’s vaccine push.

As Ohio health officials warn of the dangers and probability of contracting COVID, especially the Delta variant, among those who are unvaccinated, public health outreach campaigns and novel reward incentives have been deployed to boost Ohio’s vax rate, which has become stubbornly sluggish this summer.

“The effort has taken on new urgency as Ohio continues to lag most other states in vaccination rates and as the Delta variant of the COVID-19 virus, believed to be significantly more contagious than other variants, spreads,” the Ohio Association of Health Plans said in a statement.

Unvaccinated people account for 99% of recent deaths and 97% of hospitalizations.

Ohio Medicaid recipients can also schedule a free ride to a vaccine appointment.

Clipped from: https://www.citybeat.com/news/blog/21154322/ohioans-on-medicaid-will-get-100-if-they-get-their-first-covid-vaccine-by-sept-15

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Managed care group reports improved vax rate among W.Va. Medicaid recipients

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MCOs in West Virginia are starting a second attempt to increase the low vax rate for Medicaid members.

 
 

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.

 
 

CHARLESTON, W.Va. — The companies which administer West Virginia’s Medicaid programs report success in vaccination rates among the state’s poorest population against Covid 19.

Unicare, Aetna, and The Health Plan are the state contracted companies which are serving the poor with health care coverage in West Virginia. As it stands the average age of the clientele of those three skews very young in West Virginia’s Medicaid roles.

Ben Beakes, executive director of the West Virginia Association of Health Plans, said it’s the demographic in the Mountain State most in need of vaccination.

“The early folks who were just getting the shot on their own was the older population. Now we’re trying to push some of the younger populations,” Beakes said on MetroNews “Talkline” Tuesday.

The Justice administration’s Covid 19 task force asked Beakes and the association to help reach the Medicaid population and to hopefully up the vaccination rate earlier this year. Beakes said they’ve had several different drives to reach their clients and they are starting to see success.

Initially the managed care organizations used social medial, email, and similar campaigns to get younger people in the Medicaid population more interested in the vaccination. They plan to use additional campaigns coming up like back to school vaccinations and working to insure every person is aware of the opportunity and able to get the information about the vaccination.

“Persistence is the key. This is going to be a long-term effort, there isn’t going tob e a silver bullet to solve this issue,” he explained.

In their most recent surveys the Association found 18,000 additional Medicaid patients have been vaccinated since the effort began.

Beakes said there are two keys to their campaign. First , make sure people have all of the necessary information to answer their questions and concerns so they can make an informed decision. Secondly, he said they are working to make sure people know where they can go to get the shots.

“We understand this is a personal decision, not a requirement. Our role is to try and give them as much information as possible so they can make an informed decision. We also want to connect them with a primary care physician so they can get even more information,” he explained.

According to Beakes the top question young people had about the vaccine was how it will impact an expectant mother and her unborn baby.

 
 

Clipped from: https://wvmetronews.com/2021/07/27/managed-care-group-reports-improved-vax-rate-among-w-va-medicaid-recipients/