Oct 19, 2018

Medicaid managed care plans lack oversight

As Medicaid's rolls have swelled under the Affordable Care Act's expansion, millions more Americans have been moved into privately administered Medicaid managed care plans. But oversight of those programs is often lacking, NPR and Kaiser Health News report.

Why it matters: Medicaid managed care plans now cover more than 54 million people, and collect more than $300 billion from the states for that service.

  • "We haven't been holding plans to the level of scrutiny they need," Andrew Bindman, a former director of the Agency for Healthcare Research and Quality, told KHN.

Details, per KHN/NPR report:

"State lawmakers in Mississippi ... criticized their Medicaid program last year for ignoring the poor performance of two insurers."
"In Illinois, auditors said in January that the state didn't properly monitor $7 billion paid to Medicaid plans in 2016."
"Iowa's state ombudsman said Medicaid insurers there had denied or reduced services to disabled patients in a 'stubborn and absurd' way."
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