Medicaid patients lose HAP HMO in Metro Detroit

A total of 85,000 Medicaid patients in nine southeast Michigan counties will be dealing with new health care providers come Jan. 1 after HAP Midwest Health Plan became one of five HMOs to lose their state health contracts.

Midwest HAP, or the Midwest Health Alliance Plan, is owned by the Henry Ford Health System and was one of several health management organizations treating Medicaid patients under a 2009 state contract. When that contract was put up for rebidding by the state this year, HAP Midwest and five other HMOs lost their bids to continue treating patients on behalf of the state.

Those HMOs appealed and earlier this month one of them — Molina Healthcare of Michigan — won its appeal. HAP Midwest and the others now need to hand off their patients to new providers who will care for them after Jan. 1. HAP will continue to serve Medicaid patients in seven counties in the thumb, including St. Clair, Lapeer, Genesee Shiawassee, Tuscola, Sanilac and Huron counties.

Medicaid patients who now are being serviced by HAP in Wayne, Oakland and Macomb will be cared for by Molina, as will those in Livingston, Washtenaw, Monroe, Jackson, Lenawee and Hillsdale counties, explained Jennifer Eisner, public information officer for the Michigan Department of Health and Human Services.

The transfer doesn’t include MI Health Link or Medicare Advantage D-SNP members, according to HAP. It also doesn’t include HAP Medicaid and MI Child members in St. Clair County, who will continue to be served by HAP.

“We’re working closely with our health care plans to ensure that it’s a smooth transition for our beneficiaries — that is our priority,” Eisner said. “These health plans were chosen with that in mind, to have minimal disruption in services while ensuring that they continue to have coverage and access to care.”

Medicaid patients being treated by HAP now will continue to receive treatment and services from HAP through the end of the year, and should continue seeing those doctors and providers. “There won’t be a gap in coverage,” Eisner added. “No one’s coverage will change prior to Jan. 1.”

The state health department is mailing letters to all beneficiaries who are being assigned to new HMOs, and some of those already have been mailed. Those letters will include information on the new arrangements and a phone number to call with questions. In the meantime, HAP Medicaid patients can call the health department’s Michigan Enrolls service at 1-888-ENROLL (367655).

Susan Schwandt, HAP’s corporate spokeswoman, noted in a statement that, “We were disappointed by the state’s decision to reduce the number of Medicaid plans” in southeast Michigan, adding that “HAP Midwest’s service record has been exemplary throughout its 35-year history.”

Molina paid an unspecified amount to acquire HAP’s contract for the region. “We are pleased to welcome HAP Midwest’s Medicaid and MIChild members,” Stephen Harris, president of Molina Healthcare of Michigan, said in a statement.

Medicaid is health insurance program for low-income and needy people paid for by with state and federal money, covering children, the aged, blind, and disabled and other people receive federal assistance payments. Medicaid in Michigan expanded under the Affordable Care Act and is expected to cover 470,000 state citizens by 2021, with most of that being paid with federal dollars.

boconnor@detroitnews.com

Twitter: @BrianOCTweet