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- July 23, 2013
Medicaid Managed Care Contracts: An Advocacy Checklist for People with Disabili
Read moreMedicaid Managed Care Contracts: An Advocacy Checklist for People with Disabilities The managed care contracts between the state Medicaid agency and managed care organizations have become a new and significant legal document. In business law, the period during which the parties review a contract and investigate characteristics of the…
- July 23, 2013
EPSDT Update For Child Health Insurance and Medicaid Advocates
Read moreNovember 20, 1997 Prepared by Jane Perkins, Lourdes Rivera, and Kristi Olson--National Health Law Program Abigail English and Catherine Teare--National Center for Youth Law The Medicaid program, through its Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit package, requires states to provide comprehensive preventive, acute,…
- July 23, 2013
HCFA Letter re BBA
External Source LetterRead moreDear State Medicaid Director providing guidance re waiver requirements under BBA 1997.
- July 23, 2013
Model Medicaid Managed Care Contract Provisions — Third Party Beneficiaries
Read moreNHeLP Model Medicaid recipients enrolled in managed care are the intended third-party beneficiaries of contracts between the state and MCOs and of any subcontracts or provider agreements entered into by MCOs with subcontracting providers and, as such, enrollees are entitled to the remedies accorded to…
- July 23, 2013
Model Medicaid Managed Care Contract Provisions — Member Advocates
Read moreNHeLP Model Member Advocate Requirements -- The health plan must employ one or more member advocate(s), as specified in section 3(c) below, during the entire contract term. The member advocate(s) will work with enrollees, providers, and plan personnel to facilitate the provision of Medicaid benefits…
- July 23, 2013
Model Medicaid Managed Care Contract Provisions — A Primer on Medicaid Managed
Read moreBrief Introduction to Medicaid Managed Care Contracting To control Medicaid expenditures and expand access to health care, states are requiring Medicaid recipients to enroll in risk-based managed care programs. Although to date mandatory enrollment has affected mostly poor women and children, the behavioral health and…