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

CMS needs to get nursing home staffing information directly from payroll systems, Congressional leaders say

CMS needs to get nursing home staffing information ...

Federal regulators should start collecting nursing home staffing information directly from payroll systems as soon as possible, members of the Congressional Seniors Task Force said in a letter to a ...

Male CNA who wears women's clothing can pursue charges that nursing home ...

A Texas certified nursing assistant can continue to pursue charges that his former nursing home employer has made false, defamatory statements about him in the job referral process, a federal court recently ruled.

High-profile consumer advocacy group sues over broken Medicare appeals process

Long-term care providers have been outspoken in their criticism of the Medicare appeals process, which has all but ground to a halt. Now a class-action lawsuit says Medicare beneficiaries also are being harmed by the excessively long delays.