Protect Access to Care for New Yorkers Enrolled in Managed Medicaid
Reject the Elimination of the IDR Process from Medicaid Managed Care
Since 2015, New York’s successful IDR program has served our Medicaid Managed Care patients well. Let’s protect it!
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What is the IDR Process?
The Independent Dispute Resolution (IDR) process is a way to resolve payment disputes between health plans and providers for Medicaid Managed Care patients, typically in emergent situations.
Why Is The IDR Process Important?
The IDR ensures that Medicaid Managed Care patients have access to high-quality physician care at the point of emergent care.
What are the Benefits of maintaining the IDR process?
- Supports Healthcare Access To Vulnerable Populations.
- Ensures Specialty Physician On-Call Services at Community Hospitals.
- Independent Reviews Guarantee Fairness in Dispute Resolution.
- Reduces the Need for Litigation and Administrative Burdens.
- Ensures a High Quality of Care.
More Reasons to Reject the Elimination of the IDR Process from Medicaid Managed Care
- The IDR Is Fair: The IDR process is a middle ground that prevents extreme outcomes (patients facing huge bills or providers receiving inadequate payments) and has worked well in New York State since 2015.
- “Baseball-Style” Arbitration: The “final offer” arbitration format incentivizesboth parties to submit reasonable offers, promoting good faithnegotiations.
- Promotes Long-Term Stability: A stable and predictable IDR process isessential for the long-term health of the healthcare system, fostering trustand cooperation among stakeholders.
- Reduces the Need for Litigation: The IDR process provides a cost-effectivealternative to lengthy and expensive court battles, reducing the legalexpenses for healthcare providers, Medicaid Managed CareOrganizations, and the Medicaid program.
- Supports Healthcare Access: The IDR ensures the network of healthcareproviders are on-call and available to Medicaid Managed Carerecipients, ensuring continued access to necessary, and often life-saving,services.
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