MSDC Testimony at MCO Hearing September 30, 2025
Written by MSDC Staff
Today, MSDC President Dr. Dock Winston and Advocacy Committee Chair Dr. Klint Peebles testified before the Committee on Health at the Managed Care Organizations (MCO) roundtable. The roundtable explored how the MCOs are covering care in the District for the Medicaid population.
Dr. Winston's testimony focused on the issue of "downcoding" and the negative impact of downcoding on affordable care.
Downcoding is not just a billing tactic; it is a barrier to care. It forces physicians to spend hours appealing denials instead of seeing patients. It destabilizes independent practices that already operate on thin margins. And most importantly, it harms patients who risk losing access to thorough, comprehensive visits.
See Dr. Winston's testimony here.
Dr. Peebles testimony focused on MCO's compliance with the recently enacted prior authorization legislation.
The Prior Authorization Reform Amendment Act was an achievement to help provide equitable care to residents of the District. But without vigilant oversight, its promise risks being undermined. On behalf of our patients and the physicians who serve them, I urge this committee to continue demanding accountability and transparency from MCOs.