It started after a contracted HMO providing Medicaid managed care services said it planned to cut rates for personal care assistance. Now, a pending bill would prohibit unauthorized provider reimbursement rate decreases by other managed care organizations, as well as Medicaid and NJ FamilyCare.
“Vulnerable patients should not be blindsided with higher healthcare costs,” said State Sen. Robert Singer (R-Monmouth, Ocean), one of the bill’s sponsors. “Managed care organizations must explore all other options before seeking to decrease provider benefits via a rigorous public process.” Senate Bill 2241 passed the Senate in late November and was awaiting final approval in the state Assembly.
The rate decrease was sought by Horizon NJ Health, one of the four HMOs contracted to provide Medicaid managed care services. It would have affected home health aides’ services for high-needs children and seniors.
From: McKnight’s
Michael is an accomplished leader with deep expertise in the healthcare sector. As the CEO of Prime Source, he has driven innovation and strategic growth in healthcare procurement and management. His extensive knowledge of the industry has made him a sought-after speaker, regularly lecturing at trade groups, seminars, and to industry executives on the most pressing healthcare trends and challenges. Michael is passionate about exploring the intersection of business and healthcare, providing thought leadership that shapes the future of the field.