Medicaid Officials Warn Insurers: Reform Prior Auth Before Politicians Do

Speaking at an AHIP conference in Baltimore on March 13, two state’s top Medicaid officials shared frank views about the tensions that arise from working with private managed care plans to run their Medicaid programs — especially as scrutiny of insurer practices like prior authorization is intensifying.

“We talk a lot internally about the fact that if I were to stand somebody from my agency — the Medicaid agency — next to somebody from a Medicaid managed care company, from a mission perspective, you will not see a single difference between the two,” said Jay Ludlam, deputy secretary of NC Medicaid, during the AHIP Medicare, Medicaid, Duals & Commercial Markets Forum.

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Leslie Small

Leslie Small

Leslie has been reporting and editing in various journalism roles for nearly a decade. Most recently, she was the senior editor of FierceHealthPayer, an e-newsletter covering the health insurance industry. A graduate of Penn State University, she previously served in editing roles at newspapers in Pennsylvania, Virginia and Colorado.

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