DRO Submits Comments on Medicaid Managed Care

August 13, 2019 by Disability Rights Ohio / Medicaid

The Ohio Department of Medicaid (ODM) is preparing to take new bids for contracts from managed care providers. A managed care provider is a health insurance company ODM pays to provide health care services to some people. In Ohio, most people who have Medicaid must join a managed care plan to receive their health care.

As part of ODM’s process, they have put out a Request for Information, seeking input from the public on their experiences with the state’s managed care system. DRO also conducted a public survey to gather our own input as we prepared our comments. Forty-eight people responded, including parents, guardians, people with and without disabilities, and providers.

Overall, DRO feels that the state must address five categories of systemic issues affecting people with disabilities and their families in the managed care system. These categories are:

• The state’s managed care appeals and grievance system,
• The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program for children,
• The provider shortage and workforce crisis in Ohio,
• Imposing family or “natural supports” , and
• The need for a robust system of community-based mental health services.

DRO also endorses the comments submitted by the eight legal services organizations, who raise many important issues that impact people with disabilities, including:

• Social determinants of health and medical-legal partnerships,
• Grievances and appeals,
• Benefits and delivery systems (such as non-emergency medical transportation),
• Care coordination and case management, and
• Access and quality.

You can read DRO’s comments here, with the survey results beginning on page 14 of that document.

On July 26, the Ohio Department of Medicaid announced they would continue the comment period for an extended but undetermined amount of time. Notice of the new deadline will be posted two weeks ahead of time on the Department’s website. You can submit your own comments using this document. 

The process of Ohio’s government selecting new managed care companies will continue for at least another year and receiving consumer and stakeholder feedback is one of the first steps in the process.