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- March 9, 2015
A Guide to Oversight, Transparency, and Accountability in Medicaid Managed Care
Read moreIn this publication, NHeLP attorneys have drawn upon decades of experience to support stakeholders as they embark on, or continue to engage in, Medicaid managed care work. NHeLP's A Guide to Oversight, Transparency, and Accountability in Medicaid Managed Care provides a robust set of tools, tips, and techniques to obtain…
- January 29, 2015
Q&A: CMS Guidance on EPSDT Services for Children with ASD in Medicaid
Read moreUnder longstanding Medicaid law, the state Medicaid agency must cover particular treatments "including intensive behavioral services" if they are coverable Medicaid services, necessary to correct or ameliorate a child's ASD, and no alternative, equally effective treatment is appropriate for the child. A recent CMS guidance letter and FAQ discuss…
- December 19, 2014
Lessons from CA: Ensuring Medi-Cal Plans Provide Services to Children
Read moreIn this month's Lessons from California, we highlight how NHeLP worked to ensure that California's Medi-Cal managed care plans provide medically necessary services to children, even when those children might be able to receive some of these services from another entity. As a result of NHeLP's advocacy, California released…
- December 18, 2014
NHeLP EPSDT Letter to California Department of Health Services
Read moreThis letter urges California's Medicaid Agency to take action to instruct Medicaid Managed Care plans that they are required under state and federal law to provide services mandated by EPSDT to enrollees under 21. NHeLP and its partners become aware that several plans were refusing to cover certain services for…
