In a Nov. 17 order issued to insurers, state Medicaid officials said “members are currently in imminent danger of not receiving medically necessary healthcare services” due to SynerMed’s conduct. Some said it underscores a lack of accountability among companies involved in Medicaid managed care, which receive billions in taxpayer dollars and have expanded significantly under the Affordable Care Act. Besides managing care for Medicaid patients, SynerMed also oversaw managed care services for people on Medicare and commercial insurance — 1.2 million patients in all. SynerMed, founded in 2001, served as a key intermediary in the managed-care industry between health plans and independent physician practices. Under Medicaid managed care, the government pays a fixed rate per patient to health plans, whose job is to coordinate patient care effectively and efficiently.

Source: Los Angeles Times November 30, 2017 20:59 UTC