Can we say Bye Bye Felicia to MCOs – I bleeping hope so

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Alright – so, first, I cannot wait to retire. I went back to the capitol last week after being gone for years since the pandemic. I also have not been to the health care committees since – I think 2014 when I advocated for the autism portal. The minute I saw this building, I got a headache and had to take Tylenol. Then I took Advil when I left. Ugh. We all know the MCOs are horrible. They get public funds to provide health care to the poor in Minnesota. They are paid whether they provide the services or not which to me sounds insane. What the heck? why would the state of Minn do this? how can this possibly be cost-effective? Prepaid Medical Assistance is highway robbery. Payment should be provided to these blood-sucking insurance companies after services actually occur. At any rate, I and so many others have been trying relentlessly to change this stupid law and give patients the freedom to choose their publicly funded health care. Below is my testimony in the Senate supporting this.


Minnesota Senate

Health & Human Services

Chair: Sen. Wiklund

February 16, 2023

    Re: Supporting the Freedom to Choose and opt out of MCOs SF 404

Dear Madam Chair & Members, many thanks for the opportunity to testify today in support of SF 404.
My name is Idil Abdull. I am a Somali Autism Mom, an advocate who wants to retire, and a provider. I usually never advocate from a provider’s perspective, but I chose to do it today at least from a provider of color.
As you may have heard, autism is high in Somali children born in Minnesota. Please see the attached research and articles that should be in your folders. I also want to point to your attention the fact that Minnesota has one of the worst health racial disparities in the county. See attached articles about this as well.
My son was diagnosed with autism at age 3 and ½ years old which is considered early and good by most standards. I took him to an ABA therapy clinic. To make a long story that included lawsuits and becoming an advocate, I decided instead of always complaining about my son not getting the services that he needed; I would become an advocate and a provider.
So, at the age of 90, I went back to school and got a master’s degree in autism therapy, particularly applied behavior analysis (ABA) therapy. I partnered with my attorney and started a small ABA clinic. Our goal was and still is to serve autism families particularly Somali children as well as other black and brown autistic kids.
In parallel, as an advocate, I, and other Somali autism parents (Hodan & Istahil) and our community fought long and hard to ensure the state of Minnesota covered autism therapy for children with Medicaid. Please see attached articles, especially the Mpls Tribune one titled – double standard. With the help of Abeler, Gottwalt, Hann, Pogemiller, Berglin, Sheran, Liebling, Gov Dayton, and so many others we were able to pass what later became early intensive developmental and behavior intervention (EIDBI). This ensured MCOs covered the same services as Fee for Service. We thought our fight was over and we prevailed. We were mistaken.
There are dozens of autism therapy clinics including mine who are no longer able to serve MCO autistic children. Why you ask. When we serve a client with fee for service, DHS has straight and simple guidelines and policies to follow. They train us on how to do the treatment plans, get authorizations, do billing, and provide monthly clinical/policy hours for providers. We are able to bill every other Thursday up to 11:59pm and get reimbursed the following Tuesday for services we have provided. There is no drama and no confusion.
When we serve an MCO client who has Ucare or BCBS, there is no provider training, no billing training, and we have no idea when we are going to get reimbursed for the therapy we provided. It can take weeks to months and sometimes never. There is no support nor guidance from MCOs.
I even contacted Kathryn Kmit who directed me to connect with Mr. Andreson and Mr. Lucas Nesse whom I knew when he was the LA for Sen. Senjem. I am sorry to report neither of them cared about their members or their contracted providers. They refused to help. I then contacted CMS Chicago office and CMS Baltimore and told them what the MN Medicaid agency was doing with MCOs will only increase the racial disparity we have in Minnesota. CMS told me that they asked the state Medicaid agency to ensure the training for MCO contracted providers was the same as that of FFS. Sadly, it is not. I then contacted the person at DHS who does the MCO contracts PJ who informed me MCOs will now have one recorded training for providers. That simply is not enough. As a result, our clinic and many others have made the painful and heartbreaking decision of not being able to serve MCO autism children.
Think about that for a minute. This will now increase racial disparity. It will increase the support and resources these children will need later on in life because they are not getting early intervention.
In summary, madam chair and members, the ball is in your corner. Even though there is the saying insurance companies have more money than God. You have the power, the responsibility, and quite frankly the obligation to ensure low-income Medicaid patients have the freedom and the opportunity to choose their health care. I hope you do the right thing and vote for this bill. People’s lives and health care depend on you and your vote.

Referencing articles and research:

Mpls Tribune – Double Standard

Autism Rates higher in U.S Born Somali Children in Mpls

UofMN study funded by CDC, NIH and Autism Speaks confirms – autism IS higher in Somali kids born in Minnesota

Minnesota Racial Health Disparities


Idil Abdull – Somali Autism Mom & Advocate

The above words do not represent any candidate, agency, or committee.

Idil Abdull