Medicaid MCOs can do more on maternal health, OIG says: 5 notes

The HHS watchdog published a report Oct. 2 detailing state’s policies for Medicaid coverage and network adequacy for maternal care. 

Here are five findings to note: 

1. Medicaid is the largest payer for maternal healthcare. The majority of states, 41, use managed care organizations to run their Medicaid programs. 
2. Every state required MCOs to cover OB/GYN physicians and hospital services. However, many states did not require MCOs to cover some federally mandated services, including birth centers, nurse midwives and maternal-fetal medicine specialists. 
3. States could better use network adequacy standards to ensure access to maternal care, according to the OIG. Many states do not measure access to specific provider types, including OB/GYNs, a federal requirement, the OIG found. 
4. Some states do not tailor their adequacy standards to maternal care, including varying appointment wait time requirements by stage of pregnancy. 
5. The OIG recommended CMS take steps to confirm all states cover federally required services, clarify that states must have provider-specific standards for OB/GYN care and support states in creating network adequacy standards to better address maternal care. 

Read the full report here. 

At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.