Some 300,000 people covered by Indiana\u2019s Medicaid program will have less than two months to change their health insurance company as state officials are kicking MDwise off the provider list.<\/p>\n
The Indiana Family and Social Services Administration\u00a0announced Wednesday<\/a>\u00a0that MDwise would no longer be among the\u00a0managed care health plan options for the Healthy Indiana Plan and Hoosier Healthwise programs as of Jan. 1.<\/p>\n Indianapolis-based MDwise, which said it has provided Indiana Medicaid services for over 30 years, has already launched a court challenge to the state\u2019s action.<\/p>\n The four-year contract was signed in 2023. Indiana\u2019s transparency portal shows MDwise has receivhe ed more than $300 million over the last three fiscal years.<\/p>\n MDwise argues that FSSA officials have acted improperly in terminating the company\u2019s four-year contract that was slated to run through the end of 2026, but a Marion County judge denied a request to temporarily block the state\u2019s decision.<\/p>\n The state agency\u2019s action comes as Gov. Mike Braun\u2019s administration has been\u00a0pushing to stem the Medicaid program\u2019s fast-growing costs<\/a>\u00a0\u2014 which were projected in April to jump by 9.5% during the current state fiscal year and 7.7% next fiscal year.<\/p>\n \u201cIndiana Medicaid exists to provide dependable, high-quality care for the Hoosiers who rely on it,\u201d FSSA Secretary Mitch Roob said in a statement. \u201cOur review found that, of the four plans, MDwise was both the most expensive and the lowest in quality. Federal rules require us to maintain at least three plans, and this decision allows us to meet those standards while safeguarding members\u2019 access to care.\u201d<\/p>\n Impact on those covered by MDwise<\/p>\n The agency said those covered by MDwise\u00a0will not lose Medicaid benefits but must select new coverage from among three remaining providers \u2014 Anthem, CareSource, or Managed Health Services. Those not making a selection will be assigned to one of those plans.<\/p>\n MDwise clients will receive letters with detailed instructions on how to select a new plan, FSSA said.\u00a0<\/p>\n MDwise, a subsidiary of Michigan-based\u00a0McLaren Health Care, filed a lawsuit against the FSSA in October, seeking to head off the agency\u2019s decision. Marion County Superior Court Judge\u00a0Christina Klineman on Wednesday gave the company permission to appeal her decision rejecting a temporary restraining order against FSSA.<\/p>\n MDwise said Tuesday that FSSA officials had ignored the company\u2019s proposed performance improvement plan and a request for a three-month delay in the termination so that the company could pursue a sale to another business.<\/p>\n \u201cFSSA is trying to avoid paying the true cost of care for Hoosiers,\u201d the company said in a statement. \u201cDuring discussions with FSSA in September, it became clear that FSSA\u2019s real motivation for pursuing a termination was not MDwise\u2019s performance, but rather because the State\u2019s policies put Medicaid spending on an unsustainable path.\u201d<\/p>\n The state\u2019s decision risks disrupting medical care for MDwise clients, including pushing some to other insurers whose networks don\u2019t include the same health care providers, the company said.<\/p>\n \u201cInstead of working together toward an orderly solution, the state has chosen a rushed path that jeopardizes care for hundreds of thousands of Hoosiers,\u201d the company said. \u201cMDwise presented multiple proposals to ensure a smooth, responsible transition \u2014 all of which have been ignored.\u201d<\/p>\n \u201cDespite this setback, MDwise is not giving up. We remain committed to finding a responsible path forward that preserves access to care, protects local jobs and honors our 30-year legacy of serving Indiana\u2019s most vulnerable residents.\u201d<\/p>\n