Managed care organizations (MCOs) are also called “Medicaid management companies.” These companies are responsible for creating healthcare and mental health provider networks to serve their members. They publish directories that list all the providers in their network. However, members, providers, and auditors have discovered that many providers listed in these directories are unavailable to serve the members. “Ghost” and “phantom…
Posts tagged as “managed care organization”
Open Letter to Louisiana Legislature Regarding Children’s Services RE: Louisiana Legislative Audit, Access to Comprehensive and Appropriate Specialized Behavioral Health Services in Louisiana Friday, February 23, 2018 Dear Honorable Louisiana Senators and Representatives, The Louisiana Legislative Auditor released a performance audit on February 14, 2018, titled, Access to Comprehensive and Appropriate Specialized Behavioral Health Services in Louisiana. I believe performance…
During recent weeks, The Des Moines Register has published articles and public comment related to a managed care practice I call “half-managed care”. “Half-managed care” happens when a managed care organization interrupts care. In our experience in Louisiana, half-managed care occurs whenever a managed care organization (MCO) refuses to continue authorizing intensive residential care before a child’s treatment is complete.…