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May 30, 2024
North Carolina Tailored Plan Network Adequacy: Acute Care Hospitals Update
Daniel Young Fact Sheet
North Carolina is launching Tailored Plans on July 1, 2024 to manage the behavioral health and physical health services for beneficiaries in need of enhanced services for a mental health disorder, substance use disorder, intellectual/developmental disability (I/DD), or traumatic brain injury (TBI). A Tailored Plan’s provider network is critical…
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November 27, 2023
Continuity of Care in Medi-Cal Managed Care (Updated 2023)
Abbi Coursolle Fact Sheet
Continuity of Care (“COC”) is critical to Medi-Cal beneficiaries in a variety of circumstances. There are a number of laws and policies that govern COC for Medi-Cal beneficiaries, depending on the situation. Some of these protections are specific to Medi-Cal while others are more broadly applicable to people enrolled…
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July 14, 2023
Comments on Proposed Medicaid Managed Care Access Rule
Sarah Somers Comments
CMS proposed a major administrative rule that would increase transparency in managed care; improve monitoring and assure adequacy of payments in managed care; increase accountability, transparency, and participant input into external quality review; and help states to make information about quality measures widely available. NHeLP filed comments in support…
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July 13, 2023
Comments on Proposed Medicaid Access Rule
Jennifer Lav, Wayne Turner, David Machledt, Abigail Coursolle, Dania Douglas, Charly Gilfoil, Jasmine Young, and Madeline Morcelle Comments
CMS proposed changes and additions to regulations enforcing the "equal access" provision of Medicaid. These changes would strengthen opportunities for enrollees' input and oversight of state Medciaid programs, would help promote access to Medicaid services, would improve quality of care, and promoting transparency and adequate payment for fee-for-service Medicaid.…
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June 8, 2023
[Webinar] Managed Care
David Machledt and Daniel Young Student Webinars
A broad overview of the managed health care delivery system, what managed care is, why it’s attractive to states, the incentives managed care organizations have to cut services, and why that creates a need for accountability. This session will also cover critical policy issues including proposed changes to managed…
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May 17, 2023
Access to Medi-Cal Specialty Mental Health Services: Network Adequacy Requirements and Other Beneficiary Rights
Abigail Coursolle and Nancy Lam Issue Brief
Medi-Cal covers Specialty Mental Health Services (SMHS) for beneficiaries who need them. In California, County Mental Health Plans (MHPs) are responsible for providing SMHS to Medi-Cal beneficiaries of all ages. This issue brief analyzes the legal requirements that require MHPs to ensure Medi-Cal beneficiaries’ access to SMHS and maintain…
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North Carolina Tailored Plan Network Adequacy: Acute Care Hospitals Update

Continuity of Care in Medi-Cal Managed Care (Updated 2023)

Comments on Proposed Medicaid Managed Care Access Rule

Comments on Proposed Medicaid Access Rule

[Webinar] Managed Care

Access to Medi-Cal Specialty Mental Health Services: Network Adequacy Requirements and Other Beneficiary Rights