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- May 12, 2016
Issue Brief 2: Medicaid Managed Care Final Regulations Grievance & Appeals Systems
Read moreThis 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 governing grievance and appeals systems in Medicaid managed care (Subpart F of…
- May 11, 2016
Fact Sheet: Medicaid EPSDT Litigation – Case Trends (Updated June 2, 2016)
Read moreThe Early and Periodic Screening, Diagnostic and Treatment (EPSDT) provisions are among the most specific in the Medicaid Act. Promising both clinical care and coordination with education, nutrition and public health, EPSDT is critical for children with limited family incomes. Over the years, however, states have not been steadfast to…
- May 6, 2016
Issue Brief 1: Medicaid Managed Care Final Regulations and Health Equity
Read moreThis issue brief reviews 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, intended to ensure health equity.
- May 2, 2016
Q&A: Differences Between Marketplace and Medicaid MAGI
Read moreThis Q&A outlines a common error made by states when determining eligibility under Modified Adjusted Gross Income (MAGI), leading to unlawful Medicaid denials. MAGI rules differ for Marketplace and Medicaid eligibility determinations. Because of those differences, there may be instances in which an individual seemingly is financially ineligible for…
- April 29, 2016
Lessons from CA: Marketplace Benefits and Networks
Read moreThis month's Lessons from California highlights California's update to its Marketplace benefit design for 2017 and changes that were considered and made through a stakeholder process.
- April 26, 2016
Issue Brief: Highlights of the Medicaid Managed Care Final Regulations
Read moreHHS issued the final Medicaid Managed Care rule on April 25, 2016. This issue brief provides initial highlights of key portions of the regulations. NHeLP will issue a more extensive review of the regulation in the upcoming days and weeks.