Evers proposed to establish a government office that would be responsible for helping Wisconsinites appeal claims denied by health insurance companies.
If a certain company denies too many claims, Evers proposes to implement a new process to audit health insurance companies and make sure they are providing the best services to residents in need of care.
Falling reimbursement is just one of the challenges medical practices face today. Absent reform, the market for physician services could collapse—and consolidate power in the hands of a few huge hospitals, health systems, and vertically integrated insurers like UnitedHealth’s Optum. Such consolidation means that patients would have fewer choices in where they can seek care—and would likely pay higher prices.
The relationship between Connecticut hospitals and the Connecticut Medicaid program can sometimes sound like a bad marriage — “Can’t live with 'em but can’t live without 'em either!” The rhetoric can be heated at times, with alleged Medicaid underpayment being blamed for a myriad of problems in the health care system.
Health care providers already facing fiscal strain say that delays to MaineCare payments would exacerbate the situation and could have impacts on patient care.
What's been a brewing think-tank fight over Medicaid payments to hospitals and doctors could soon spill onto the main political stage should Republicans decide this is the most politically palatable way to cut the program's spending by hundreds of billions of dollars.