Managed care organizations (MCOs) play a critical role in providing access to health care for the majority of Washington’s Medicaid (Apple Health) enrollees. But there are questions about how well MCOs are doing their job in providing care, particularly given a recent analysis by the Office of the Inspector General that found that MCOs denied 1 out of every 8 provider requests for prior authorization of services nationally. Of the MCOs operating in Washington in 2019, the denial rates were 8.4% for Coordinated Care of WA, 11.5% for UnitedHealthcare, 14% for Amerigroup, and the highest, a whopping 19.3% denial rate for Molina Healthcare. (The report studied the 7 MCOs with the largest enrollment across the country and one of WA’s MCOs, Community Health Plan of Washington, was below that threshold.)

NoHLA’s upcoming CLE Webinar, “Advancing Patient Rights for a New Era,” on October 20th from 8:45 am to 3:00 pm PDT (3.5 Law and Legal and 1.75 Other CLE Credits, pending) will feature a panel discussion on MCOs from a variety of perspectives, including an overview of the most common problems, the legal basis for accountability, successful advocacy and litigation efforts, and how one state has managed its Medicaid program without managed care.

Join NoHLA staff member Leslie Bennett and “Addressing Challenges in Accessing Medicaid Managed Care” panelists:

• Elizabeth Edwards, J.D., Senior Attorney, National Health Law Program, works with NHeLP’s  litigation team to advance the health rights of low income and underserved individuals, including policy advocacy and legal education;
• David Machledt, Ph.D., Senior Policy Advocate, National Health Law Program, focuses much of his work on managed care quality and accountability, Medicaid demonstrations and waivers, and health care affordability;
• Dan Young, M.P.H., Policy Analyst, National Health Law Program, works on research, writing, and policy analysis on Medicaid, managed care quality, maternal and child health, and health equity; and
• Sheldon Toubman, J.D., Litigation Attorney, Disability Rights Connecticut, has 35 years of experience working for legal services and disability rights programs in Pennsylvania and Connecticut with demonstrated success advancing clients’ access to health care. 

Other CLE Webinar sessions include: improving equity in health care; protecting patient privacy rights; and addressing the escalating costs of health care. We’ll also hear from state agency leaders about recent legislative changes and upcoming regulatory and strategic initiatives.

Registration and information is available on the CLE Webinar’s homepage. 

Interested in supporting the CLE webinar by becoming a sponsor? Email Michelle Johnson for more information.