Advocates Seek Action After DMAS “Prenatal Care Secret Shopper Survey” Reveals MCOs Not Providing Care They Are Paid to Provide

PRESS CONFERENCE ADVISORY FOR:
• Tuesday, July 9, at 10:30 AM
• House Briefing Room, 2nd floor, General Assembly Building

Speakers:
Rev. Dr. LaKeisha Cook M.Ed. Div., D. Min, Co-Executive Director, Virginia Interfaith Center for Public Policy (VICPP); Nichole Wardlaw, CNM, DNP, FACNM, American College of Nurse-Midwives (ACNM); Stephanie Spencer, BSN, RN, BA, LCCE, CLC, Founder and Executive Director, Urban Baby Beginnings (UBB);
Victoria Richardson, Esq., Staff Attorney, Virginia Poverty Law Center (VPLC); Emily Moore, Senior Policy Analyst, Voices for Virginia’s Children; Kenda Sutton-EL, Founder and Executive Director, Birth in Color; Kathryn Haines, Health Equity Manager, Virginia Interfaith Center for Public Policy (VICPP)

RICHMOND, VA [7/03/2024]- The PUSH Coalition is calling on lawmakers, the Department of Medical Assistance Services (DMAS), and advocates to hold Virginia Medicaid Managed Care Organizations (MCOs) accountable. The Virginia General Assembly and the Governor have acknowledged racial disparities in maternal and infant mortality. DMAS recently released a “Prenatal Secret Shopper Survey” as part of the 2023 External Quality Review and Technical Report revealing that the majority of prenatal care providers who are enrolled with the Virginia Medicaid MCOs are not providing services.

A Managed Care Organization (MCO) is a structured health plan designed to provide comprehensive healthcare services to its members. The “Secret Shopper” posing as an enrolled patient seeking care had trouble accessing care. According to the report, in 95 percent of overall cases (n=1,844) providers were unable to be reached, did not offer prenatal care services, were not at the sampled location, did not accept the requested MCO, did not accept VA Medicaid, were not accepting new patients, or were unable to offer an appointment date.

In Virginia, there are five MCOs. Over 90% of Medicaid-eligible Virginians receive Medicaid services through an MCO. Medicaid-eligible folks enroll with an MCO, and the MCO receives a monthly fee or capitation payment for that enrolled person to provide health services. Enrolling in Medicaid means a monthly check for the MCO, but it does not necessarily mean prenatal care for a pregnant mom.

On July 1, four of the five MCO contracts were renewed. We invite the media to this press conference as we ask that MCOs report publicly on a monthly basis how they are partnering with Community Based Organizations (CBOs) to address barriers to accessing maternal and infant healthcare and that the Governor’s administration offer DMAS their full support to hold MCOs accountable.

About the PUSH Coalition: The PUSH Coalition is convened and led by The Virginia Interfaith Center for Public Policy and consists of over 20 organizations and advocates. There are seven that will be representing PUSH at the press conference they are: Virginia Interfaith Center for Public Policy, Voice for Virginia’s Children, Virginia Poverty Law Center, Urban Baby Beginnings, Birth in Color, American College of Nurse-Midwives and Virginia Midwives Alliance. The coalition’s objective is to make maternal healthcare equitable to all within the Commonwealth of Virginia.