Medicaid HMOs may need state OK to cut rates

Share this article:
New Jersey State Sen. Robert Singer (R)
New Jersey State Sen. Robert Singer (R)

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. 


Share this article:

More in News

Medicare rates could be adjusted for start and end of hospice care ...

Medicare payments could be adjusted to reflect how hospice services tend to be more intensive at the beginning and end, according to findings recently published by the Centers for Medicare & Medicaid Services Office of Information Products & Data Analytics.

Nursing home resident dies after allegedly being smothered by son

A terminally ill nursing home resident in Ohio has died after his son is alleged to have smothered him, according to police.

Medicare should pay for skilled nursing services without a qualifying hospital stay, experts tell Senators

Medicare should pay for skilled nursing services without ...

The time has come to eliminate hospital stay requirements for beneficiaries to qualify for Medicare coverage of skilled nursing services, experts told a Senate committee Wednesday.