Title
Authorizing the Committee on the Disabled & Persons with Special Needs to hold hearings regarding Pennsylvania’s HealthChoices initiative.
Body
WHEREAS, In February 2015, Governor Tom Wolf announced the laudable decision that the Commonwealth would adopt the full benefits of Medical Assistance expansion provided by passage of the Affordable Care Act; and
WHEREAS, To transition coverage from the prior program to a value-based model, the Pennsylvania Department of Human Services (“DHS”) issued a Request for Proposals (“RFP”) seeking managed care organizations (“MCOs”) to serve in the Health Choices program, the awards of which resulted in a lawsuit over the award process; and
WHEREAS, After litigation, DHS issued a new RFP, beginning a second round of applications, which was unfortunately complicated due to a scoring error and completion of which has raised a number of procedural and substantive concerns about continuity of care; and
WHEREAS, The final awards significantly affect coverage of proper treatment and preventive services for 1 of every 5 recipients in southeast Pennsylvania, including approximately 87,500 HealthChoices recipients in Philadelphia; and
WHEREAS, The shift from many incumbent MCOs to only three calls into question the early experiences of health providers entering into value-based arrangements and longer-term implications for patient care; and
WHEREAS, Reliable, accessible health care is critical to every Philadelphian, making the transition of MCO a matter of intense public interest; now, therefore, be it
RESOLVED, BY THE COUNCIL OF THE CITY OF PHILADELPHIA, That council does hereby authorize the Committee on the Disabled & Persons with Special Needs to hold hearings regarding Pennsylvania’s HealthChoices initiative.
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