New Ohio Medicaid Director Inherits Concerns Over Funding, Drug Middlemen | WOSU Radio

New Ohio Medicaid Director Inherits Concerns Over Funding, Drug Middlemen

Mar 5, 2019

Ohio's new Medicaid director is taking the helm as the department faces multiple questions about its future.

Maureen Corcoran took the job in January. The next month, Gov. Mike DeWine asked the department to re-bid the contracts of private health insurance companies that manage the majority of the program’s money. 

Multiple state legislators introduced bills that would change the way the department works, from creating a "personal responsibility initiative," which would require Medicaid expansion enrollees to pay certain premiums and co-pays, to raising the work requirement age from to 65.

The legislature already passed the bill that created work requirements for Medicaid expansion recipients, but its details have yet to be approved by the federal government. Several other states already had their work requirement waivers approved by the Trump administration.

"We have been engaged in negotiations with CMS and are optimistic that will be wrapped up relatively soon," Corcoran says.

In the meantime, one of the pharmacy benefit managers the department contracts with has been accused of overcharging the Bureau of Workers Compensation, to the tune of $16 million. The state attorney general is working to recoup that money.

Corcoran says Medicaid's program operates differently than the BWC, with many federal requirements imposed, but adds that they are closely examining their relationship with OptumRX. 

"Looking for not only improvements in quality but ways we can be more transparent about the services and to reduce the cost to the state," she says.  

The department is also preparing to present its budget proposal to the General Assembly. Corcoran's predecessor Barbara Sears warned that changes to federal contributions to the Children’s Health Insurance Program (CHIP) will cost Ohio an additional $200 million in the two-year budget.

Corcoran says that change is just one part of a larger picture. 

"We don't tend to look at just the CHIP component as separate or different from Medicaid," she says. "That's why looking at it in its entirety is important."