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June 24, 2022

State Managed Medicaid Under Scrutiny

With the onset of new federal reporting requirements for State Medicaid plans, states are being forced to take a hard look at costs per patient. As such, several lawsuits have been filed by a variety of states against Medicaid Managed Care Organizations. Louisiana recently filed suit against UnitedHealthcare of Louisiana and OptumRx, owned by UHC, stating the two companies are working together to inflate what UHC of Louisiana pays to OptumRx, in order to inflate the medical loss ratio amount. Other states are focusing on care coordination, fighting fraud, waste and abuse, and other cost saving initiatives.

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