Meet Your Managed Care Partners: Advocacy

Administration officials announced last week the five insurance companies (aka Managed Care Organizations or MCOs) who have submitted bids in response to the KanCare proposal to overhaul Medicaid services.  While some of these companies have subsidiaries in areas of Kansas, they are all nationally headquartered in other states – meaning massive profits will go to out-of-state companies at the expense of Kansans.  Of these five companies, three will be granted the contract to manage Medicaid programs for the elderly, the disabled, the mentally ill and persons with  intellectual/developmental disabilities.

While officials have expressed confidence in these potential MCOs, some research indicates cause for concern.  Below are some examples of what's being said of our potential partners across the country...


WHAT’S BEING SAID ABOUT COVENTRY HEALTH CARE & WELLCARE IN KENTUCKY?


“Why don’t you communicate with these people enough that they don’t call us when they don’t get paid?” – Kentucky Sen. Tom Buford said in a hearing regarding managed care in which providers expressed concerns over lack of payment from Coventry Health Care and Wellcare. (The Courier Journal)

“Please make it stop” – Kentucky Sen. Julie Denton said in response to email complaints regarding lack of payment from Coventry Health Care and Wellcare. (The Courier Journal)

“[Managed care is] causing drastic cash flow problems.  The payment issue has been very significant” – Kip Boman, Kentucky Home Care Assoc. said to legislators in a hearing regarding managed care. (The Courier Journal)

WHAT’S BEING SAID ABOUT CENTENE & WELLCARE BY STANDARD & POOR’S?

Standard & Poor’s gave Centene a rating of BB, placing it in a rating category entitled “Vulnerable: Marginal/Extremely Weak”. (Northwestern Mutual Life Insurance Company)

Standard & Poor’s gave Wellcare a rating of ≤B, placing it in a rating category entitled “Vulnerable: Marginal/Extremely Weak”. (Northwestern Mutual Life Insurance Company)



WHAT’S THE US DEPARTMENT OF JUSTICE SAYING ABOUT AMERIGROUP?


Amerigroup Settles Federal & State Medicaid Fraud Claims for $225 Million - headline from a 2008 news release by the US Department of Justice.



WHAT’S BEING SAID ABOUT UNITED HEALTH CARE?
United Health Care was one of three organizations recently dropped from managing Connecticut’s Medicaid services: “Connecticut has a 15-year history with managed-care organizations, and there has been a diminishing confidence in the value of what they are providing” Mark Schaffer, Connecticut Medicaid director. (USA Today)