Medicaid challenge

Above is a recent letter sent out by our ISMA president. In addition, here is the latest on the Medicaid challenge.

As reported from the ISMA, the Medicaid MCO’s challenging the proposed changes loses the first fight in court.

• Harmony Health Plan lost a lawsuit asking a Marion Superior Court judge to review the state’s policies and procedures in awarding managed care contracts. The company filed a lawsuit Sept. 1 after the Indiana Family and Social Services Administration did not renew its contract to manage the state’s health insurance program for low-income Hoosiers.
  

The Judge hearing the case dismissed it on Sept. 24 and cited the following reasons:

• Harmony lacked standing to bring the claims it asserted
  

• Harmony failed to exhaust its administrative remedies
  
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• Harmony failed to state a claim for which relief could be granted

They can appeal and the other two companies have dropped their legal battle after this verdict.

The new companies are supposed to have signed contracts with physicians by November 1st, but many are going to wait. It will then place the burden on the MCO’s to offer a better deal than what they currently propose.