Women's Health
MSDC has long advocated for women's health protections, the rights of women physicians, and affordable care for women's issues. MSDC works closes with ACOG, AAFP, AAP, and other specialty organizations to craft local legislation that allows DC to be the best place to practice women's and maternal medicine.
In the face of a maternal mortality crisis in the District, engagement in these issues is more important than ever. Learn more about how MSDC is working to protect the health of women, mothers, and babies in all wards in the city.
MSDC Statements and Testimony on Women's Health Issues
25th Council information coming soon!
Report: DC MCO Had 20% Prior Auth Denial Rate
In 2019, a DC Managed Care Organization (MCO) denied 20% of prior authorizations submitted, higher than any other state.
A recently published report by the Department of Health and Human Services (HHS) Office of the Inspector General reveals the District government lacks recommended oversight procedures for overseeing prior authorizations in the managed care system. In 2019 - the most recent year for data - that led to very high rates of denials by District MCOs. See the entire report here.
The report comes from Congressional requests to HHS on how MCOs are providing patient care. The OIG reviewed data from the largest MCOs nationally and compared their denial rates nationally and at the state level. For DC, this meant AmeriHealth and Amerigroup were included in the study. The most recent year data was available was 2019.
Nationally, AmeriHealth Caritas had a prior auth denial rate of 6.1%. DC's denial rate was 20%, the highest in any state AmeriHealth served. Anthem, Amerigroup's parent company, had a 12.9% denial rate nationally but "only" a 14.1% denial rate in the District.
Even more disturbing is the lack of documented oversight into this process by the District government. The study looked at three oversight categories:
- States regularly reviewed prior authorization denials for appropriateness
- State used denials data for oversight
- State offered external medical reviews
DC did not meet the criteria for the second or third, and was labelled as "ad hoc" for the first.
This data shows the importance of ensuring all payers, including the MCOs, are included in B25-124, the Prior Authorization Reform Amendment Act. You can help us pass this important legislation by:
- Attending our Council Visit Day to provide your perspective.
- Contacting your Councilmember's office.
- Sharing your story with MSDC and volunteering to sit for a media interview on the topic.
Sample of Legislation MSDC Followed in Women's Health and Maternal Health
(See the whole list of bills here)
What does the bill do? Extends postpartum inpatient and outpatient benefits to at least one year after childbirth
MSDC position: We support this legislation and the extension of insurance benefits to mothers and babies to help maternal health in the District
Current status: SUCCESS. The bill passed the Council and was signed into law by the Mayor on August 14, 2020.
What does the bill do? The bill prohibits the District government from interfering with patients' reproductive health decisions and prohibits employers from punishing physicians who perform abortions or sterilizations outside of their employment.
MSDC position: We support this legislation as it allows physicians freedom of practice.
Current status: SUCCESS. The bill passed the Committee on Government Operations in January. MSDC submitted testimony at the December hearing, and MSDC member Sara Imershein testified at the hearing. The Council passed the bill and the Mayor signed it into law on March 23, 2020.
What does the bill do? The bill extends coverage for maternal health issues and fertility preservation, creates a Maternal Health Center in the District, and mandates two hours of cultural competence CME for health care providers.
MSDC position: We oppose the bill without changes due to inclusion of mandatory CME and some of the definitions in the bill being medically questionable.
Current status: The bill had a hearing in the Committee on Health in December, with MSDC member Dr. Sara Imershein testifying for MSDC and ACOG.