Updated: Apr 30
Charleston, W.Va.: The managed care organizations (MCOs) that manage West Virginia’s Medicaid Program are planning a series of actions aimed to give flexibility to the provider community during the COVID-19 pandemic. The MCOs have discussions scheduled this week with the Bureau for Medical Services (BMS) to establish protocols which will assist healthcare providers address COVID-19 related care.
“The MCOs understand the burden COVID-19 is placing on our state’s healthcare community. We want to be a partner with them, to assist during this pandemic and will be announcing certain steps each MCO will take to ease their burden and ensure rapid delivery of quality care,” said Ben Beakes, executive director of the West Virginia Association of Health Plans. “The MCOs have already heard from certain provider groups on certain pressure points they are experiencing or expect to experience. We are committed to working with them while continuing to ensure the integrity of the Medicaid Program.”
MCOs have already removed prior authorization requirements for testing and treatment associated with COVID-19. Further, the MCOs have enacted contingency plans to protect the health of their own employees, many of whom are care managers for some of our most vulnerable citizens. “Many Medicaid members rely on the communication from our care managers, the majority of whom are registered nurses, to help them navigate the healthcare system. Our care managers work to find alternative treatment plans for our members when necessary and ensure members are adhering to medical directives for their specific diagnoses,” said Beakes. “While we work to provide some flexibility to the provider community, we also are focused on seamless delivery of services to Medicaid members in the face of the growing pandemic.”
MCOs will communicate with providers once further plans are finalized early next week.