Here are 10 recent Medicaid updates highlighted by Becker’s since August 17th: North Carolina’s expansion delay due to budget complications, concerns about call center wait times in over a dozen states, Texas HHS whistleblower complaint, data breach affecting beneficiaries’ info, Michigan’s Medicaid care management search, Florida lawsuit over coverage termination, misleading insurance ads, COVID-19 unwinding leading to 5M+ disenrollments, physician leadership in Medicaid managed care, and Rep. Frank Pallone Jr.’s inquiry into authorization denials.
In recent times, Medicaid has been making waves in the news with a series of developments worth noting. Here’s a compilation of 10 updates on Medicaid that Becker’s has covered since August 17th.
1. Delay Looms for North Carolina’s Medicaid Expansion: The anticipated Medicaid expansion in North Carolina might face postponement until 2024. The expansion’s funding hinges on the approval of the state’s 2023-2024 budget, which has hit a roadblock within the state’s legislative process.
2. Concerns Arise Over Medicaid Call Centers: Over a dozen states have experienced extended wait times and high rates of call abandonment in their Medicaid call centers, as per the CMS report.
3. Whistleblower Complaint Targets Texas HHS: Anonymous Texas Health and Human Services employees have lodged a whistleblower complaint against the agency, citing an array of system issues leading to inaccurate termination of health coverage during Medicaid redeterminations.
4. Data Breach Affects Medicaid Beneficiaries: A major ransomware attack on the MOVEIt software application exposed personal information, including Social Security numbers and medical histories, of Medicaid beneficiaries in Oregon, Indiana, Missouri, and Colorado.
5. Michigan’s Medicaid Care Management Initiatives: Michigan is in search of contractors to oversee Medicaid care for a population exceeding 2.2 million. The state’s health and human services department is introducing fresh criteria to ensure network adequacy and timely access to care for managed care plans.
6. Lawsuit Alleges Medicaid Coverage Termination: Families in Florida filed a proposed class-action lawsuit on August 22nd, accusing the state of terminating their Medicaid coverage without proper notice or an opportunity to contest the decision.
7. Misleading Online Insurance Advertisements: Individuals seeking insurance after losing Medicaid coverage encounter misleading advertisements for limited-benefit plans, as highlighted by a report from the Georgetown University Center for Health Insurance Reforms in Washington, D.C.
8. Unenrollments Amidst COVID-19 Unwinding: The conclusion of the COVID-19 public health emergency has led to the disenrollment of more than 5 million people from Medicaid, with procedural reasons accounting for over 74% of these cases as of August 29th, based on KFF data.
9. Physician Leadership in Medicaid Managed Care: Many states entrust private insurers to deliver health benefits through Medicaid, often led by physicians. A list of 10 Medicaid managed care organizations with physician presidents or CEOs is now available.
10. Inquiry into Medicaid Managed Care Authorization Denials: U.S. Rep. Frank Pallone Jr. has initiated an inquiry into prior authorization denials by Medicaid managed care organizations.
