Mayor Muriel Bowser declared a health systems emergency in the District over the status of the city’s Medicaid contract with MedStar health, which more than 200,000 residents rely on for health care.
The emergency order went into effect Wednesday, giving members of her administration the authority to do “what’s necessary or appropriate to protect the health and safety” of residents. Wayne Turnage, deputy mayor of health and human services, told WTOP Monday that Bowser would declare the order “to avoid a potential disruption.”
MedStar makes up 31% of the District’s Medicaid claims, the order said. If the current contract is left to expire, thousands of D.C. residents who rely on the Medicaid managed care program will lose access to non-emergency care on Sept. 30.
“The reverberations from the loss of Medstar from the managed care program will echo through the District’s entire health care system with a significant and pernicious impact,” the order said.
Using her power under the Home Rule Act, the 15-day emergency order states “because of a decision by the Contract Appeals Board, the Medstar contract may not be extended under the 2020 solicitation.”
Last year, a judge ruled the contract with Medstar ineligible after allegations that District employees, including Turnage, shared propriety details of the procurement process with council members and others outside the process.
Turnage denied the allegation, and said the city plans to re-bid the Medicaid contract, but that the process could take 10 months — time that the city does not have with less than 30 days until the current contract expires.
As part of its action plan, the order confirms that on Aug. 20, Medstar notified the other managed care plans in the $1.5 billion dollar contract that it “intends to cancel or modify the network-sharing agreements” on Nov. 18, which would drive up costs for those companies.
“The reverberations from the loss of Medstar from the managed care program will echo through the District’s entire health care system with a significant and pernicious impact,” the order states.
Of those enrolled in the Medicaid managed care program, 31% have health conditions that place them at “substantial risk for an adverse outcome if they become infected with Covid 19,” it said, underscoring the importance that residents have access to health care in the middle of a global pandemic.
