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Mississippi Today

Medicaid awards managed care contracts after two-year stalemate

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mississippitoday.org – Gwen Dilworth – 2024-08-28 15:35:10

Medicaid awards managed care contracts after two-year stalemate

Three companies will begin new contracts to manage the care of Mississippi Medicaid beneficiaries in July of 2025, barring further legal holdups. 

For-profit, incumbent companies Magnolia and Molina Healthcare and new, nonprofit TrueCare were each awarded four-year, $3.8 billion contracts beginning Aug. 12.ย 

The contracts were stalled for two years โ€“ since August 2022 โ€“ after two companies that weren’t chosen filed protests with the alleging that the blind bidding process was unfair and reviewers were not properly blinded to the identities of applicants. The issue is still being litigated in court.

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Enrollment in new plans should begin in May 2025, said Mississippi Medicaid spokesperson Matt Westerfield. 

The contracts were awarded after Mississippi Medicaid issued one-year emergency contracts last month to Magnolia Health, Molina Healthcare and UnitedHealthcare โ€“ the companies currently contracting with the state for managed care services โ€“ for the second year in a row, giving new contractors time to implement services. 

The state’s managed care program, MississippiCAN, seeks to lower costs and improve access to medical services for the state’s most vulnerable citizens, children, people with disabilities and pregnant women. Beneficiaries of the Children’s Health Insurance Program, which provides low-cost health coverage to children in families that exceed Medicaid’s income ceiling, also receive coordinated care services. 

Managed care companies receive per-member payments to maintain a provider network and implement programs intended to improve health outcomes for enrollees.

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Nearly three-fourths of the state’s 653,916 Medicaid recipients were enrolled in MississippiCAN services in July 2024. 

The effectiveness of managed care programs has been widely debated. Some people argue that managed care companies are incentivized to offer effective preventative care services to members in order to avoid high-cost medical services, while critics argue that their profits are made by denying or limiting services to

Mississippi is one of 40 states that has adopted the managed care organization model for coordinating benefits, according to the National Conference of State Legislatures. The state began its program in 2011.

Mississippi Medicaid has awarded $37.8 billion in state and federally-funded contracts to four managed care companies since 2017. 

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They represent the largest contracts awarded in the state in at least the last 10 years, according to the state’s contract database. 

Magnolia Health, owned by St. Louis-based Centene, has provided managed care services to the state since 2011. In 2021, Centene operated managed care programs in 29 states, according to data from KFF.

Magnolia Health has netted $14.9 billion in contracts from the state since 2017, more than any other managed care company. 

California-based Molina Healthcare has provided managed care services to the state since 2017, receiving $8.6 billion in contracts. In 2021, it operated managed care programs in 16 states.

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They are some of the most profitable companies in the nation. In 2023, Centene and Molina Healthcare reported nationwide profits of $2.7 billion and $1.1 billion, respectively.

TrueCare is a not-for-profit company established by Mississippi hospitals and the state hospital association to provide an alternative to traditional managed care companies. The company vied for a managed care contract in 2017, but was not selected during the process. 

Richard Roberson, incoming of the Mississippi Hospital Association and CEO of TrueCare. Credit: Jerry Mitchell/MCIR

Richard Roberson, CEO of TrueCare and incoming president and CEO of the Mississippi Hospital Association, said the goal of the nonprofit is to improve health outcomes for patients and lower care costs. 

Because the company is governed by providers, it will be less likely to deny claims and more motivated to use preventative care to avoid costly care, Roberson said. 

โ€œI think there is a place for managed care if we’re truly managing care, and not just managing claims,โ€ he said. 

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Contract controversy

Centene, the company that owns Magnolia Health, settled with the state for $55 million in 2021 amidst an investigation by Attorney General Lynn Fitch and State Auditor Shad White into whether the company inflated prescription drug bills to the Division of Medicaid. 

โ€œI do not care how large or powerful the company is, Mississippi taxpayers deserve to get what they paid for when the state spends money on prescription drugs,โ€ said White in a statement at the time. 

The company did not admit fault or wrongdoing under the agreement.

The in 2022 rejected a proposal by Rep. Becky Currie, R-Brookhaven, to prohibit the Division of Medicaid from hiring managed care companies that have settled with the state over allegations of fraud. 

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โ€œI am for doing away with doing business with a company who took $55 million dollars of our money that was supposed to be spent on the poor, the sick, the elderly, the mentally ill, the disabled,โ€ she said during discussion on the House of Representatives floor. 

Magnolia officials at the time said the settlement amount of $55 million did not represent the alleged amount of fees the state was overcharged.

State Medicaid Director Drew Snyder argued the bill could cause a lapse in care for Medicaid beneficiaries and lead to a legal quagmire. 

Drew Snyder, Mississippi Division of Medicaid executive director, speaks during the Medical Care Advisory Committee meeting at the Woolfolk State Office Building in , Miss., Friday, Sept. 22, 2023. Credit: Eric Shelton/Mississippi Today

Centene was one of the largest contributors to Gov. Tate Reeves’ gubernatorial campaign in 2023. The company and its political action committee (PAC) have donated $370,000 to Reeves since 2010. It has also donated to many state legislators’ campaigns, according to public documents on the Secretary of State’s website.

A standoff

The contract selection process itself also attracted scrutiny.

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Mississippi Medicaid began seeking new contracts for managed care in December 2021, with plans to begin the contracts in July 2023. The division’s โ€œrequest for qualificationsโ€ yielded five responses.

The agency announced its selection of Magnolia Health, Molina Healthcare and TrueCare in August 2022. 

A protracted legal battle began one later when the two companies that weren’t chosen โ€“ Amerigroup and UnitedHealthcare โ€“ cried foul, arguing that the selection process was unfair.

The review process used a blind bidding process to evaluate applications while keeping the identities of the companies hidden. 

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The companies argued the state failed to properly โ€œblindโ€ contract evaluators to the identities of applicants by allowing companies to include identifying information in their application.

โ€œProtests in state Medicaid managed care procurements are a near certainty,โ€ Medicaid spokesperson Matt Westerfield told Mississippi Today in an email. โ€œ… It’s just become part of doing business for the companies that don’t win.โ€ 

The Division of Medicaid denied the protests in June 2023. The Public Procurement Review Board, the body responsible for reviewing contract acquisition processes, denied a subsequent appeal in April 2024. 

The Public Procurement Review Board ruled that the Division of Medicaid properly carried out blind scoring procedures. 

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Amerigroup and UnitedHealthcare turned to the courts in April and May, respectively, when they sued the Division of Medicaid and the Public Procurement Review Board, aiming to halt the contracts from being awarded. 

Westerfield acknowledged that the court’s adjudication process could alter the state’s plan to begin the new contracts in July 2025, but said the division did not expect any delays. 

Minnesota-based UnitedHealth Group, which owns UnitedHealthcare, currently provides managed care services to Mississippi Medicaid beneficiaries. It generates more money than any other U.S. health care company, according to Becker’s Hospital Review.  In 2023, the company reported $23.1 billion in net earnings. It provided managed care services to 26 states in 2021.

In the state’s 2023 external audit of managed care organizations, UnitedHealthcare met 98% of standards for MississippiCAN. Magnolia met 97% and Molina met 92%.

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Amerigroup has not held a contract for managed care service in Mississippi. It is owned by Minneapolis-based Elevance Health.

Magnolia Health, Molina Healthcare and UnitedHealthcare did not respond to requests for comment for this story.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Mississippi Today

A Mississippi town moves a Confederate monument that became a shrouded eyesore

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mississippitoday.org – Emily Wagster Pettus, Associated Press – 2024-09-18 14:17:57

A Mississippi town moves a Confederate monument that became a shrouded eyesore

GRENADA (AP) โ€” A Mississippi town has taken down a Confederate monument that stood on the courthouse square since 1910 โ€” a figure that was tightly wrapped in tarps the past four years, symbolizing the community’s enduring division over how to commemorate the past.

Grenada’s first Black mayor in two decades seems determined to follow through on the city’s plans to relocate the monument to other public land. A concrete slab has already been poured behind a fire station about 3.5 miles (5.6 kilometers) from the square.

But a new fight might be developing. A Republican lawmaker from another part of Mississippi wrote to Grenada officials saying she believes the city is violating a state that restricts the relocation of war memorials or monuments.

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The Grenada City Council voted to move the monument in 2020, weeks after police killed George Floyd in Minneapolis. The vote seemed timely: Mississippi legislators had just retired the last state flag in the U.S. that prominently featured the Confederate battle emblem.

The tarps went up soon after the vote, shrouding the Confederate soldier and the pedestal he stood on. But even as people complained about the eyesore, the move was delayed by tight budgets, state bureaucracy or political -dragging. Explanations vary, depending on who’s asked.

A new mayor and city council took office in May, prepared to take action. On Sept. 11, with little advance notice, police blocked traffic and a work crew disassembled and removed the 20-foot (6.1-meter) stone structure.

“I’m glad to see it move to a different location,” said Robin Whitfield, an artist with a studio just off Grenada’s historic square. “This represents that something has changed.”

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Still, Whitfield, who is white, said she wishes Grenada leaders had invited the community to engage in dialogue about the symbol, to bridge the gap between those who think moving it is erasing history and those who see it as a reminder of white supremacy. She was among the few people watching as a crane lifted parts of the monument onto a flatbed truck.

“No one ever talked about it, other than yelling on Facebook,” Whitfield said.

Mayor Charles Latham said the monument has been “quite a divisive figure” in the town of 12,300, where about 57% of are Black and 40% are white.

“I understand people had and stuff to fight and die in that war, and they should be proud of their family,” Latham said. “But you’ve got to understand that there were those who were oppressed by this, by the Confederate flag on there. There’s been a lot of hate and violence perpetrated against people of color, under the color of that flag.”

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The city received permission from the Mississippi Department of Archives and History to move the Confederate monument, as required. But Rep. Stacey Hobgood-Wilkes of said the fire station site is inappropriate.

“We are prepared to pursue such avenues that may be necessary to ensure that the statue is relocated to a more suitable and appropriate location,” she wrote, suggesting a Confederate cemetery closer to the courthouse square as an alternative. She said the Ladies Cemetery Association is willing to deed a parcel to the city to make it happen.

The Confederate monument in Grenada is one of hundreds in the South, most of which were dedicated during the early 20th century when groups such as the United Daughters of the Confederacy sought to shape the historical narrative by valorizing the Lost Cause mythology of the .

The monuments, many of them outside courthouses, came under fresh scrutiny after an avowed white supremacist who had posed with Confederate flags in photos posted online killed nine Black people inside the historic Emanuel African Methodist Episcopal Church in Charleston, South Carolina, in 2015.

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Grenada’s monument includes images of Confederate president Jefferson Davis and a Confederate battle flag. It was engraved with praise for “the noble men who marched neath the flag of the and Bars” and “the noble women of the South,” who “gave their loved ones to our country to conquer or to die for truth and right.”

A half-century after it was dedicated, the monument’s symbolism figured in a rights march. When the Rev. Martin Luther King Jr. and other leaders held a mass rally in downtown Grenada in June 1966, Robert Green of the Southern Christian Leadership Conference scrambled up the pedestal and planted a U.S. flag above the image of Davis.

The cemetery is a spot Latham himself had previously advocated as a new site for the monument, but he said it’s too late to change now, after the city already budgeted $60,000 for the move.

“So, who’s going to pay the city back for the $30,000 we’ve already expended to relocate this?” he said. “You should’ve showed up a year and a half ago, two years ago, before the city gets to this point.”

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A few other Confederate monuments in Mississippi have been relocated. In July 2020, a Confederate soldier statue was moved from a prominent spot at the University of Mississippi to a Civil War cemetery in a secluded part of the Oxford campus. In May 2021, a Confederate monument featuring three soldiers was moved from outside the Lowndes County Courthouse in Columbus to another cemetery with Confederate soldiers.

Lori Chavis, a Grenada City Council member, said that since the monument was covered by tarps, “it’s caused nothing but more divide in our city.”

She said she supports relocating the monument but worries about a lawsuit. She acknowledged that people probably didn’t know until recently exactly where it would reappear.

“It’s tucked back in the woods, and it’s not visible from even pulling behind the fire station,” Chavis said. “And I think that’s what got some of the citizens upset.”

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This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Crooked Letter Sports Podcast

Podcast: New Orleans sports columnist and author Jeff Duncan joins the podcast to talk about his new Steve Gleason book and the new-look New Orleans Saints.

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mississippitoday.org – Rick Cleveland and Tyler Cleveland – 2024-09-18 10:00:00

Jeff Duncan went from the Mississippi Book in on Saturday to Jerry World in Dallas on Sunday where he watched and wrote about the Saints’ total dismantling of the Dallas Cowboys. We about both and also about what happened in high school and college football last and what’s coming up this weekend.

Stream all episodes here.

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This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

On this day in 1899

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mississippitoday.org – Jerry Mitchell – 2024-09-18 07:00:00

Sept. 18, 1899

Credit: Wikipedia

Scott Joplin, known as โ€œthe King of Ragtime,โ€ copyrighted the โ€œMaple Leaf Rag,โ€ which became the first song to sell more than 1 million copies of sheet music. The popularity launched a sensation surrounding ragtime, which has been called America’s โ€œfirst classical music.โ€ย 

Born near Texarkana, , Joplin grew up in a musical . He worked on the railroad with other family members until he was able to earn money as a musician, traveling across the South. He wound up playing at the World’s Fair in Chicago in 1893, where he met fellow musician Otis Saunders, who encouraged him to write down the songs he had been making up to entertain audiences. In all, Joplin wrote dozens of ragtime songs. 

After some , he moved to New York , hoping he could make a living while stretching the boundaries of music. He wrote a ragtime ballet and two operas, but success in these new forms eluded him. He was buried in a pauper’s grave in New York City in 1917. 

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More than six decades later, his music was rediscovered, initially by Joshua Rifkin, who recorded Joplin’s songs on a record, and then Gunther Schuller of the New England Conservatory, who performed four of the ragtime songs in concert: โ€œMy faculty, many of whom had never even heard of Joplin, were saying things like, โ€˜My gosh, he writes melodies like Schubert!’โ€ 

Joplin’s music won over even more admirers through the 1973 , โ€œThe Sting,โ€ which won an Oscar for the music. His song, โ€œThe Entertainer,โ€ reached No. 3 on Billboard and was ranked No. 10 among โ€œSongs of the Centuryโ€ list by the Recording Industry Association of America. His opera โ€œTreemonishaโ€ was produced to wide acclaim, and he won a Pulitzer Prize in 1976 for his special contribution to American music.ย 

โ€œThe ragtime craze, the faddish thing, will obviously die down, but Joplin will have his position secure in American music history,โ€ Rifkin said. โ€œHe is a treasurable composer.โ€

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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