Press Release: Councilmember Vincent C. Gray’s Statement on Destabilization of the District’s Managed Care Program

News Release — Ward 7 DC Council member Vincent Gray

FOR IMMEDIATE RELEASE                              

Friday, August 27, 2021

Contact: Sheila Bunn

Washington DC – “I am deeply concerned about recent developments that have destabilized the District’s managed care program.  First and foremost, my goal is to ensure that DC residents insured through Medicaid and the DC HealthCare Alliance have equitable access to high quality health care services.  When the District adopted a process of universal contracting last year, the 250,000 District residents who are insured through Medicaid and the Alliance managed care programs, gained access to every hospital, Federally Qualified Health Center, and hospital-based physician and specialist.  This should have permanently ushered in a new era of health equity in the District of Columbia.

However, due to a technical problem with the contracting process, MedStar Family Choice was disqualified from renewing the option years of its managed care contract, which were slated to begin on October 1, 2021, even though they followed the directives of the Office of Contracting and Procurement in submitting their proposal.  The Council had an opportunity to remove this barrier in the Budget Support Act through a proposed subtitle allowing MedStar to participate in the Contract Appeals Board’s reevaluation process, but by a 7-6 vote, the Council declined to support the Executive’s legislation. 

In response to being disqualified from renewing its MCO contact, MedStar, not surprisingly, has removed its discounted Medicaid pricing structure, thus forcing a renegotiation with the remaining two MCO plans.  If these new pricing requirements are not met, none of the 250,000 Medicaid or Alliance managed care enrollees would have access to any MedStar hospital, clinic, rehabilitation facility, or specialty care physicians, except for persons experiencing health emergencies handled through MedStar’s Emergency Departments. 

During both the 2017 and 2020 Medicaid managed care procurements, I have deliberately avoided playing favorites between Amerigroup and MedStar, and instead have insisted upon a fair and competitive process…and that remains my position today.  While the Medicaid Program can persist without MedStar Family Choice MCO, any scenario where MedStar’s health system is not a part of the District’s Medicaid Program is simply unacceptable. 

The elimination of the MedStar health system from the District’s Medicaid Program would cause extraordinary wait times among the remaining hospital providers and create chaos throughout our health system at a time when we can least afford it.  This turmoil would be especially harmful because many of those served through these programs are among the District’s most medically fragile residents.

I call upon Mayor Bowser and her Administration to propose a solution that retains access to MedStar health care services for our residents insured through Medicaid and the Alliance.  We also must ensure that enrollees do not have to switch insurance coverage multiple times, or that any residents lose access to their current physicians and specialists by retaining DHCF universal contracting.  Above all else, our next step forward must provide the solution that is best for the 250,000 residents who receive their health insurance through the District’s public system.”

#####