Delivery System Reform Archive

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September 1, 2016
Q&A: Adequacy of Medicaid Fee-For-Service Payments Final Rule
Sarah Somers Issue Brief
The federal Centers for Medicare & Medicaid Services (CMS) have issued final regulations establishing a process for states to comply with the Medicaid Act's requirements that payments be sufficient to ensure adequate provider participation in the program. This Q&A discusses those requirements and provides tips for advocates who want…
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August 31, 2016
Issue Brief 6: Medicaid Managed Care Final Regulations: Older Adults
Leo Cuello and Andy DiAntonio Issue Brief
In this issue brief, Leonardo Cuello reviews the recently finalized Medicaid managed care regulations, and how they impact access to health care for older adults. He highlights important new provisions in the regulations on a range of topics such as enrollment protections, network adequacy requirements, long-term services and supports…
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July 18, 2016
Issue Brief: Why Are Medicaid Lock-in Programs Used and How Can They Be Improved
Jane Perkins Issue Brief
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June 30, 2016
Q&A: Recoupment Following an Adverse Medicaid Appeal
Jane Perkins Issue Brief
Legal Director Jane Perkins provides guidance on a question regarding Medicaid managed care plans' abilities to recoup costs of health services following an adverse Medicaid appeal. Medicaid applicants and recipients have rights to notices and administrative hearings when their claims for medical assistance are denied or not acted on…
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June 23, 2016
Issue Brief 5: Medicaid Managed Care Final Regulations and Reproductive Health
Catherine McKee Issue Brief
In this issue brief, NHeLP Staff Attorney Catherine McKee reviews the recently finalized Medicaid managed care regulations, and how they impact access to quality reproductive health services. She notes the new rules are "designed to increase access to reproductive health providers and services," but says state health care advocates…
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June 10, 2016
Issue Brief 4: Medicaid Managed Care Final Regulations: Quality and Transparency
David Machledt and Wayne Turner Issue Brief
This issue brief will review selected provisions in the final rule, Medicaid and Children's Health Insurance Program (CHIP) Programs, Medicaid Managed Care, CHIP Delivered in Managed Care, and Revisions Related to Third Party Liability implementing the requirements concerning quality and transparency. The final rule advances quality assessment, transparency and…
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Q&A: Adequacy of Medicaid Fee-For-Service Payments Final Rule

Issue Brief 6: Medicaid Managed Care Final Regulations: Older Adults

Issue Brief: Why Are Medicaid Lock-in Programs Used and How Can They Be Improved

Q&A: Recoupment Following an Adverse Medicaid Appeal

Issue Brief 5: Medicaid Managed Care Final Regulations and Reproductive Health

Issue Brief 4: Medicaid Managed Care Final Regulations: Quality and Transparency