HAP Urges DHS to Support Medicaid Access to Care

Proposed contract language could jeopardize access for thousands of PA patients

March 24, 2022

A proposed change to Pennsylvania’s Physical Health Medicaid Managed Care program, known as HealthChoices, could limit access to health care for tens of thousands of working families, mothers, children, and people with chronic health conditions.

This week, HAP and a coalition of leading Pennsylvania health care organizations are urging the Pennsylvania Department of Human Services (DHS) not to include proposed collective bargaining provisions in the state’s contracts with HealthChoices Medicaid managed care organizations (MMCO). MMCOs are the organizations that facilitate access to care through Medicaid.

DHS and other state officials are reviewing a contract proposal that would effectively block any hospital that has experienced one or more work stoppages in the past five years from participating in Medicaid unless they reach a collective bargaining or labor peace agreement.

The clause could preclude more than a dozen hospitals, including sole community providers in some rural areas, from serving people in their community covered by Medicaid, the coalition notes.

“Simply put, the proposed contract provisions will jeopardize access to care for Medicaid beneficiaries in communities across the commonwealth,” the coalition said in the letter.

Jeff Bechtel, HAP’s senior vice president, health economics and policy, emphasized the need to address the issue during today’s Medical Assistance Advisory Committee meeting. He highlighted concerns about health outcomes, access in rural communities, and disruption of services for patients with Medicaid.

The council plans to discuss the contract provisions again during its meeting next month.

“For a number of reasons, we are concerned that it will jeopardize access to care for Medicaid consumers,” he said of the contract provision.

HAP continues to advocate against inclusion of contract provisions that create new barriers to care. The administration of the Medicaid managed care program should be designed to meet the needs of it beneficiaries, ensuring they can receive the care they need to live healthy lives.

In addition to correspondence earlier this month, HAP raised similar concerns in a letter to Acting DHS Secretary Meg Snead during January.

For more information, contact Jeff Bechtel, HAP’s senior vice president, health economics and policy.