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New REPORT ON MAXIMUS' MEDICAID FAILURES
GCAP | Nov. 11, 2019
As the leading provider of Medicaid administration services, millions of Americans rely on MAXIMUS for access to critical health services. But the company’s track record is increasingly under scrutiny from state leaders over performance failures and harm to beneficiaries.
“Maximum Harm: MAXIMUS’ Medicaid Management Failures”—a new report by GCAP—documents significant problems with MAXIMUS’ performance on Medicaid contracts in nine states and the District of Columbia and points the way forward for better oversight.
The report shows that problems at MAXIMUS have impeded vulnerable Americans from accessing health services they desperately needed. MAXIMUS has also been implicated in Medicaid fraud and performance failures that affected health care provider payments and the security of health system information.
maximus' bOTCHED KANSAS MEDICAID PERFORMANCE LEADS TO CALLS FOR INSOURCING
Kansas awarded MAXIMUS a contract to operate the KanCare Clearinghouse when the state privatized its Medicaid eligibility services. MAXIMUS underbid and understaffed the contract, and failed to adequately train staff, leading to poor performance that resulted in harms to Medicaid applicants and enrollees, particularly seniors and eldercare providers.
The Kansas City Star published an op-ed from public interest organization In the Public Interest (ITPI) in August 2019 calling on Kansas to cut its ties with MAXIMUS. According to ITPI, insourcing the Kansas Medicaid eligibility work performed by MAXIMUS could save taxpayers money while improving service quality for Kansans and lifting labor standards—including pay and benefits—for frontline Medicaid workers.