By Susan Feigin Harris and Summer D. Swallow on Posted in Uncategorized
The Centers for Medicare & Medicaid Services (CMS) recently issued a 1,425-page regulation (Rule) on managed care in Medicaid and the Children’s Health Insurance Program (CHIP), dubbed the first overhaul of these regulations in over a decade. CMS also issued nine “fact sheets,” indicating the Rule “supports delivery system reform efforts, strengthens program integrity by improving accountability … Continue Reading
The Texas Legislature in Senate Bill 760 removed barriers to Medicaid recipients receiving healthcare services and required improved access for services through managed care plans. Expedited Provider Credentialing The legislation requires that Medicaid managed care organizations (MCO) establish and implement an expedited credentialing process that would allow certain applicant providers to provide services to recipients … Continue Reading
By Susan Feigin Harris and Summer D. Swallow on Posted in Uncategorized
Approximately a quarter of all Medicaid expenditures is spent on the more than half of all beneficiaries (approximately 39 million by 2011 figures cited in the 2014 MACPAC Report) currently accessing part or all of their benefits through capitated, risk-bearing health plans or managed care organizations (MCOs). Although the government’s reliance on MCOs to manage … Continue Reading
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