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.
Cincinnati-based revenue cycle managment company Ensemble says that former HCA Healthcare CFO Bill Rutherford has joined its board of managers. Rutherford recently retired from HCA Healthcare after 34 years. During his tenure, he oversaw financial operations including the Treasury Department, Office of the Controller, Information Technology, Government Programs, Strategic Resource Group and Revenue Cycle Operations. Rutherford joins a board that includes Jane Moran, CIO at Mass General Brigham.
Rep. Timothy Reeder (R-Ayden), an emergency room physician from Pitt County, said that reforming the prior authorization process in the state will be at the top of his legislative agenda. Reeder co-sponsored a bill to improve prior authorization during the 2023-24 legislative session.
According to a 2023 survey by the American Medical Association, 94% physicians indicated that prior authorization, the process by which physicians are required to receive health insurance companies’ approval before providing medical service, had delayed their patients’ care. Of the 1,000 physicians surveyed, 24% reported that prior authorization delays caused direct harm to patients.