Managed Care was again the topic of discussion for the House Human Services on May 9 as they took several hours of testimony.

The committee has been charged by the House Speaker with studying managed care, including “provider satisfaction within…managed care programs.”

Jason Fuller, Chief Operating Officer of Charleston Health Care and a member of THCA’s Data Reimbursement Committee, testified on behalf of the association.

Fuller told legislators that Accounts Receivable (AR) balances are still more than three times higher than they were prior to implementation of Medicaid Managed Care in 2015. He also that the time needed to deal with AR’s has quadrupled under the new model “with no increase in payments to cover” the spike in administration.

He also described the increase from one data source previously to up to eight different websites providers now may face through TMHP and MCO portals.

In addition, Fuller raised the issue of late payments. Data shows the time providers wait for payment after billing has increased from 2-5 days prior to implementation to 7-14 days in December, 2017.

Fuller called for streamlining MCO demands and making payments more timely so providers can focus more on resident services and less on administrative oversight.