The Ohio Department of Medicaid's second solicitation of
feedback for the upcoming managed care bidding process shows the agency took
providers' concerns to heart, numerous provider groups said in a memo to ODM
Director Maureen Corcoran.
More than 20 associations representing physicians, hospitals
and others signed on to a letter to Corcoran last week commending ODM for the
direction taken in its second request for information (RFI) in the managed care
re-procurement cycle.
Signatories include the American College of Emergency
Physicians Ohio Chapter; LeadingAge Ohio; Ohio Academy of Family Physicians;
Ohio Alliance of Recovery Providers; Ohio Association of Community Health
Centers; Ohio Association for Treatment of Opioid Dependence; Ohio Children's Alliance;
Ohio Children's Hospital Association; Ohio Community Corrections Association;
Ohio Council of Behavioral Health and Family Services Providers; Ohio
Counseling Association; Ohio Dental Association; Ohio Emergency Medicine
Physicians Alliance; Ohio Health Care Association; Ohio Hematology Oncology
Society; Ohio Hospital Association; Ohio Pharmacists Association; Ohio
Psychiatric Physicians Association; Ohio Renal Association; Ohio Speech &
Hearing Governmental Affairs Coalition; and Ohio State Medical Association.
Gov. Mike DeWine directed ODM to re-bid managed care
contracts at the outset of his administration. The department put out its first
RFI in June, seeking a more general array of feedback. The second RFI, issued a
few weeks ago, indicates the ways ODM is seeking to build a more individualized
care system and outlines roles for other vendors aside from managed care
companies to assist in that goal. (See The Hannah Report, 2/4/20,
6/13/19.)
The provider groups said they were particularly heartened
by indications ODM will try to standardize how providers deal with managed care
plans.
"We are especially encouraged by the recognition of
and support for increased standardization and reduced administrative burden in
key areas such as billing, medical necessity determinations, credentialing and
prior authorization processes among others. While these administrative issues
may not appear to be transformative on their face, they will impact the
Medicaid system in a profound way. As providers, we know that there is
currently a huge administrative burden caused by six different standards and
processes for daily activities like billing and prior authorization. This
burden not only makes our work more costly and complex, but more importantly,
it impedes the time and resources available for actual patient care. In the
most simple, real world terms, we believe that streamlining these standards and
processes means Medicaid providers can spend more time and resources actually
treating the patient instead of shuffling through paperwork. It also means that
more providers may be willing to accept Medicaid patients, thereby increasing
access to care in a very meaningful way," the memo states.
The associations said they plan to give more detailed
feedback on the second RFI as well, "both collectively and as individual
organizations."