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June 12, 2015
Health Advocate: Medicaid Managed Care: Modernized Federal Regulations Have Finally Been Released
Sarah Somers Health Advocate
On June 1, the Centers for Medicare & Medicaid Services issued a proposed rule that overhauls the Medicaid managed care regulations for the first time since 2002. These changes will not only affect millions of Medicaid beneficiaries, but will have a profound impact on providers, health plans and state…
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May 14, 2015
Survey of Medicaid Managed Care Contracts: EPSDT Vision and Hearing Services
Jane Perkins, Sarah Somers, and External Source Issue Brief
An estimated 25 percent of all school children in the United States have some type of vision problem significant enough to affect daily life and school performance. Similarly, despite the proliferation of hospital-based newborn hearing screening programs, a significant number of children with possible hearing loss are not receiving…
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May 5, 2015
Medicaid Assessments for Long-Term Supports & Services (LTSS)
David Machledt Issue Brief
Long-term care needs assessments serve a vital role in Medicaid. For individuals with disabilities and older adults, needs assessments are used to determine eligibility for both institutional and home and community-based services (HCBS). The assessment process establishes the type and extent of an individual's care needs, which inform the…
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April 16, 2015
Q&A: Person Centered Planning Changes
Elizabeth Edwards Issue Brief
Due to regulatory changes and guidance issued over the past year, states should have evaluated and likely changed their person-centered planning process for home and community-based services. This Q&A focuses less on the regulatory changes and more on the important features of the current requirements for person-centered planning and…
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March 23, 2015
Webinar: Guide to Oversight, Transparency, and Accountability in Medicaid Managed Care
David Machledt and Wayne Turner Webinar
In this webinar presentation, NHeLP walks through its recently released Guide to Oversight, Transparency, and Accountability in Medicaid Managed Care. The Guide provides a robust set of tools, tips, and techniques on how to obtain information about states' Medicaid managed care programs. The webinar highlights how advocates, policy makers,…
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March 16, 2015
Fact Sheet: Accountable Care Organizations in Medicaid
Sarah Somers Issue Brief
Accountable Care Organizations (ACOs) are entities that agree to provide coordinated care to enrollees and are eligible for incentive payments if they improve health and reduce costs. ACOs have been used in Medicare for several years but, until recently, much less so in Medicaid. That is beginning to change.…
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