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Providers and Advocates Warn of Patient Harm as PASS Transition Disrupts Continuity of Care

STATE AGENCIES & GOVT'L AFFAIRS-SENATE · April 24, 2019
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Summary

Providers, residential-care operators and parent advocates told legislators the rollout disrupted primary-care relationships, pharmacy access and services for vulnerable patients; witnesses urged DHS and PASSs to prioritize continuity and to publicize ombudsman and escalation contacts.

During a joint legislative hearing, clinicians, parent advocates and residential-care operators described instances in which Medicaid beneficiaries temporarily lost ready access to their usual primary care clinicians or pharmacies after PASSs moved to managed care modules on March 1.

Multiple legislators and witnesses recounted cases where primary-care assignments disappeared from beneficiary panels after the system switch and pharmacies received real-time rejections at the point of adjudication that cited providers as "not enrolled." Pharmacists said those point-of-sale denials prevented them from filling essential…

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