Senator Robert Casey

Insurance companies overseeing Medicaid managed care programs are under investigation, the U.S. Office of Inspector General announced last week.

The OIG will be reviewing medical and dental services, and drug prescription denials, by the managed care organizations overseeing Medicaid beneficiaries. A final report is expected next year.

Investigators said they will be examining whether the Medicaid managed care contracts incentivized savings for federal and state governments that resulted in improperly denying beneficiary claims. There are 281 MCO contracts in the U.S., according to the Kaiser Family Foundation’s Medicaid Managed Care Market Tracker.

Sen. Bob Casey (D-PA), the ranking member on the Special Committee on Aging, sent a letter to the OIG expressing concern about the managed care groups, which triggered the review. Casey noted reports by newspapers, including the Des Moines Register, that followed beneficiaries who couldn’t receive services. Providers also have complained about slow reimbursement processes.

Managed care has grown by leaps and bounds in recent years, producing mixed reactions. Iowa, for example, said last year that it had saved $126 million from privatizing Medicaid, half of what had been predicted. State officials said in August 2018 they were giving program managers Amerigroup and UnitedHealthcare an additional $103 million because the insurers were sustaining losses. UnitedHealthcare said last month it was leaving the program.