Managed Care Expansion Postponed Until Oct. 1
The expansion of Medicaid managed care in 13 western Pennsylvania counties has been postponed one month until Oct. 1.
As was previously reported in Connections, the HealthChoices New West Zone was to become effective on Sept. 1. With the delay, ACCESS Plus and the Voluntary Managed Care program will now end Sept. 30 and MCOs will go into effect on Oct. 1 for Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Forest, Jefferson, McKean, Mercer, Potter, Venango and Warren counties.
The implementation was postponed because of bid protests that delayed the enrollment process. These issues have been resolved, however DPW said the extra time will allow for more outreach and education for consumers and providers and more MCO provider recruitment and network building.
Open enrollment for the 125,000 Medicaid recipients, including 92,000 Access Plus recipients, in these counties will now be Aug. 9 to Sept. 6. Recipients of ACCESS Plus or in United Health Voluntary MCO who do not choose by Sept. 6 will be auto-assigned to a new MCO. The MCOs selected for this zone include AmeriHealth Mercy Health Plan, Coventry Cares, Gateway Health Plan and UPMC for You.