WASHINGTON – Sen. Chuck Grassley today introduced legislation that would make sure Medicaid programs give beneficiaries an updated list of participating doctors.
“In some states, there are no directories of participating doctors at all. In others, there are out of date directories that include deceased doctors and doctors who aren’t taking new Medicaid patients,” Grassley said. “State and federal taxpayers pay for Medicaid beneficiaries to receive service. When patients don’t know where to go, they can’t get treatment, and the program doesn’t work the way it should. This bill is a common sense move to help make sure Medicaid reflects the modern practice of medicine.”
Grassley said the state of Iowa already provides an updated directory through its existing fee-for-service Medicaid program and so sets an example of best practices for other states.
The Grassley bill, the Medicaid Directory of Caregivers, S. 2618, would require state Medicaid programs that operate on a fee-for-service or primary care case management basis to publish an electronic listing of physicians who have billed Medicaid in the prior year. This recent billing is an indication that the physician accepts Medicaid beneficiaries. The listing on the state’s Medicaid website would include the physician’s name, business address, telephone number, and specialty.
Medicaid enrollees served by managed care organizations already have the benefit of a health plan and its provider directory of participating doctors.
A companion bill, H.R. 3821, is pending in the House of Representatives. The House sponsors noted that the Government Accountability Office (GAO) identified access to care as one of the key issues facing the Medicaid program and that “maintaining and improving access to care is critical to ensuring that the program is effective for the individuals who rely on it.” The GAO said 38 states cited challenges in ensuring enough participating providers in the Medicaid program.
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