---------- Forwarded message ---------
From: Betters, Jordan (Council) <jbetters@xxxxxxxxxxxx>
Date: Fri, Aug 27, 2021 at 2:07 PM
Subject: PRESS STATEMENT: Councilmember Vincent C. Gray’s Statement on
Destabilization of the District’s Managed Care Program
To:
*FOR IMMEDIATE RELEASE*
Friday, August 27, 2021
*Contact:* Sheila Bunn
sbunn@xxxxxxxxxxxx | (202) 724-8068
*Councilmember Vincent C. Gray’s Statement on Destabilization of the
District’s Managed Care Program*
Washington DC – "I am deeply concerned about recent developments that have
destabilized the District’s managed care program. First and foremost, my
goal is to ensure that DC residents insured through Medicaid and the DC
HealthCare Alliance have equitable access to high quality health care
services. When the District adopted a process of universal contracting
last year, the 250,000 District residents who are insured through Medicaid
and the Alliance managed care programs, gained access to every hospital,
Federally Qualified Health Center, and hospital-based physician and
specialist. This should have permanently ushered in a new era of health
equity in the District of Columbia.
However, due to a technical problem with the contracting process, MedStar
Family Choice was disqualified from renewing the option years of its
managed care contract, which were slated to begin on October 1, 2021, even
though they followed the directives of the Office of Contracting and
Procurement in submitting their proposal. The Council had an opportunity
to remove this barrier in the Budget Support Act through a proposed
subtitle allowing MedStar to participate in the Contract Appeals Board’s
reevaluation process, but by a 7-6 vote, the Council declined to support
the Executive’s legislation.
In response to being disqualified from renewing its MCO contact, MedStar,
not surprisingly, has removed its discounted Medicaid pricing structure,
thus forcing a renegotiation with the remaining two MCO plans. If these
new pricing requirements are not met, none of the 250,000 Medicaid or
Alliance managed care enrollees would have access to any MedStar hospital,
clinic, rehabilitation facility, or specialty care physicians, except for
persons experiencing health emergencies handled through MedStar’s Emergency
Departments.
During both the 2017 and 2020 Medicaid managed care procurements, I have
deliberately avoided playing favorites between Amerigroup and MedStar, and
instead have insisted upon a fair and competitive process…and that remains
my position today. While the Medicaid Program can persist without MedStar
Family Choice MCO, any scenario where MedStar’s health system is not a part
of the District’s Medicaid Program is simply unacceptable.
The elimination of the MedStar health system from the District’s Medicaid
Program would cause extraordinary wait times among the remaining hospital
providers and create chaos throughout our health system at a time when we
can least afford it. This turmoil would be especially harmful because many
of those served through these programs are among the District’s most
medically fragile residents.
I call upon Mayor Bowser and her Administration to propose a solution that
retains access to MedStar health care services for our residents insured
through Medicaid and the Alliance. We also must ensure that enrollees do
not have to switch insurance coverage multiple times, or that any residents
lose access to their current physicians and specialists by retaining DHCF
universal contracting. Above all else, our next step forward must provide
the solution that is best for the 250,000 residents who receive their
health insurance through the District’s public system."
#####
Jordan M. Betters, Staff Assistant/Scheduler
Office of Councilmember Vincent C. Gray, Ward 7
Chairman, Committee on Health
John A. Wilson Building
1350 Pennsylvania Avenue, NW
Suite 406
Washington, DC 20004
Email: jbetters@xxxxxxxxxxxx
Office: 202.724.8068
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Attachment:
PRESS STATEMENT - CM Gray's Statement on DC Managed Care Program (8.27.21).pdf
Description: Adobe PDF document
