The Kansas Department of Health and Environments decision to press and keep pressing Aetna Better Health on its performance as a Medicaid contractor is wise. Pushing to hold state contractors accountable makes a difference for those served and sends a signal that incomplete or incompetent service wont be accepted.
The problems identified with Aetna were basic ones. There were questions about what doctors were covered, about authorization of procedures and being reimbursed. These arent the kinds of fiddly problems that challenge patients and providers in the private insurance arena. These are the kind of problems that made it difficult for KDHE to know if Aetna was fulfilling some of its most basic duties.
But KDHE didnt just raise the problem. State agencies have done so with other contractors before, and for years. In previous administrations, that would sometimes result in revised contract terms that were more favorable to the private companies, or even increased payments to them.
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