Health Advocate: Medicaid Managed Care: Modernized Federal Regulations Have Finally Been Released

Executive Summary

On June 1, the Centers for Medicare & Medicaid Services issued a proposed rule that overhauls the Medicaid managed care regulations for the first time since 2002. These changes will not only affect millions of Medicaid beneficiaries, but will have a profound impact on providers, health plans and state and local officials. The proposed regulations include more specific requirements for provider network standards and accountability, yet give states the authority to determine characteristics of their managed care programs, including accessibility. This month’s issue of the Health Advocate summarizes some of the major provisions in the proposed rule.