Kaiser Health News: ‘Milestone’ Rules Would Limit Profits, Score Quality For Medicaid Plans

Kaiser Health News: ‘Milestone’ Rules Would Limit Profits, Score Quality For Medicaid Plans

By Jay Hancock

Sweeping proposals disclosed Tuesday would create profit guidelines for private Medicaid plans as well as new standards for the plans’ doctor and hospital networks and rules to coordinate Medicaid insurance more closely with other coverage.


Sarah Somers, an attorney with the National Health Law Program, which has long urged updates to federal regulations, praised proposed safeguards for Medicaid members with disabilities and limited English ability.

“The regulations governing network adequacy have some positive aspects,” she added. “But we are concerned that they do not contain the specificity that we recommended.” Read the full article here. »

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