Should managed care be able to run a state Medicaid program...it appears to be one legal mess here...and the legalities go on and on...BD
Connecticut isn't alone in cracking down on the private insurers that manage Medicaid services. Some states, such as New York, have enacted antifraud laws. Some are requiring quality reviews and increased fines, and some turned to secret shoppers to gauge their marketing tactics. The steps, which can help states save millions of dollars, could accelerate as the weak economy squeezes state budgets and boosts enrollment in Medicaid programs.
Mr. Toubman has been fighting Medicaid managed care since Connecticut first adopted it in 1995. He has filed numerous appeals, mostly successful, for clients -- typically single parents with chronic illnesses -- to get medications and other care that managed care providers denied.
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