On July 30, the Ohio Academy of Family Physicians submitted recommendations to Ohio Department of Medicaid Director Maureen Cochran relative to the Medicaid Managed Care contract reprocurement process. Also submitted separately was specific feedback of OAFP members who commented per a request that the OAFP sent to members in late June.
The OAFP and a group of co-signing organizations worked together for several months to analyze universal concerns relative to current contract provisions with managed care plans (MCPs). The group developed a list of recommendations designed to increase capacity so that access to care for Medicaid consumers is ensured. Efforts were made to model these recommendations after what is already being done in other states, as well as what is successful in Ohio’s commercial insurance marketplace.
- Prompt pay
- Reimbursement rates
- Prohibition of all products clauses
- Timely submission
- Claims denials
- Credentialing
- Medicaid Necessity Determinations
- Network Advocacy
- Payment recoupment
- Provider termination.
In addition to these comments submitted in writing, Medicaid officials will meet with any interested OAFP members on Friday, August 2, from 4-5 p.m. prior to the start of the OAFP Family Medicine Celebration. The meeting will be held in the Scioto Room at the Grand Event Center in Columbus, OH. Don’t miss this incredible opportunity to provide feedback to improve Medicaid managed care.