News Briefs

Molina Healthcare Inc. and two of its subsidiaries have been accused of providing subpar care and overbilling the government for children’s behavioral health services by $20 million, Axios reported on Aug. 13. A recently unsealed lawsuit obtained by the news outlet — which was first filed in 2018 — alleges that Molina billed for some care as though it was provided by a professional even when it wasn’t, failed to give some providers proper training, provided care for some children who weren’t eligible to receive it and fired an employee who complained about such practices. Axios’ article noted that Molina did not respond to a request for comment. Visit https://bit.ly/2PSrqIB to learn more.

New Mexico Health Connections, a consumer operated and oriented plan (CO-OP) that offered health plans on the state’s individual insurance exchange, will shut down on Jan. 1, 2021, according to an Aug. 10 press release. “With continued high claims costs and limited opportunities for new investment, it has become clear that the amount of growth required to provide quality care at reasonable rates will be unlikely in the next plan year,” said Marlene Baca, the CO-OP’s president and CEO. New Mexico Health Connections previously filed a lawsuit challenging the formula used to calculate payments in the Affordable Care Act risk adjustment program, arguing it disadvantages smaller and newer health plans. New Mexico Health Connections is the latest in a long string of CO-OPs that have folded amid challenging market conditions on the ACA exchanges. Read more at https://bit.ly/343Tyk2.

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AIS Health Staff

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