Half of Listed Medicaid Doctors Unavailable, OIG Report Finds
Many physicians listed in plans under contract with Medicaid are unavailable to treat beneficiaries, according to an HHS Office of Inspector General report released Tuesday, the New York Times reports.
Medicaid enrolled about nine million new beneficiaries in the last year, with the program growing by about 16%. Many new beneficiaries are covered through managed care plans that feature a list of available physicians.
For the report, researchers contacted about 1,800 providers included on such lists for about 200 Medicaid managed care plans in 32 states.
Overall, the researchers found that half of the listed providers were unable to offer beneficiaries appointments. Specifically:
- More than one-third of providers could not be found at the locations listed;
- 8% were at the listed location but did not participate in the plan under which they were listed; and
- 8% were at the listed location and participated in the plan, but were not accepting new patients.
The report also gathered information about wait times among providers who offered appointments. It found:
- A median wait time of two weeks;
- More than one-quarter of providers had wait times longer than one month; and
- 10% had wait times that longer than two months.
Wait times were longer among specialists than general practitioners, but specialists were more likely to offer appointments.
CMS Administrator Marilyn Tavenner agreed with report recommendations to correct errors and ensure Medicaid beneficiaries are able to access care. "Inaccurate provider directory data may unnecessarily delay an enrollee from selecting a provider," she said.
In addition, CMS Division of Managed Care Plans Director James Golden said he is in the process of creating rules and standards to improve timely access to care for beneficiaries (Pear, New York Times, 12/8).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.