I don’t know about you but I would have a reaction of sheer terror if I were told that I suddenly owed $433 million due to an error in classifying Medicaid eligible members over two years. That is what the State of Florida and the federal government now face.
This is strange to me because a lot of Medicaid MCOs do extensive analysis in preparation for premium rating season where negotiations w/the State Medicaid Agency occur. the MCO typically will analyze member’s claims experiences including diagnosis codes to determine the spend and severity of each category of member premiums.
I’d hate to be that person who was responsible for that.