A new state policy in the Medicaid managed care system could threaten hospitals. It allows insurance companies to reimburse providers at 90% of the Medicaid managed care rate if the provider is not “in network” with the insurer.
Tim Wolters with Citizens Memorial Hospital in southwest Missouri’s Bolivar says the insurance companies now have an unfair advantage in the negotiating process.
Steve Edwards with southwest Missouri’s CoxHealth says the only beneficiaries of the policy are insurance companies.
The state agency that handles delivery of Medicaid says the new policy is intended to encourage providers to participate in the managed care system. The Missouri House Budget Committee is holding a hearing Tuesday where hospital administrators are expected to voice concerns about the new policy.
