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July 23, 2013
Model Medicaid Managed Care Contract Provisions — Member Advocates
dfitzgerald Manual/Report
NHeLP Model Member Advocate Requirements -- The health plan must employ one or more member advocate(s), as specified in section 3(c) below, during the entire contract term. The member advocate(s) will work with enrollees, providers, and plan personnel to facilitate the provision of Medicaid benefits…
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July 23, 2013
Model Medicaid Managed Care Contract Provisions — A Primer on Medicaid Managed
Jane Perkins Manual/Report
Brief Introduction to Medicaid Managed Care ContractingTo control Medicaid expenditures and expand access to health care, states are requiring Medicaid recipients to enroll in risk-based managed care programs. Although to date mandatory enrollment has affected mostly poor women and children, the behavioral health and disabled populations are increasingly being…
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July 23, 2013
Model Medicaid Managed Care Contract Provisions — Medical Necessity Definition
dfitzgerald Issue Brief
Introduction The definition of "medical necessity" raises two general issues of concern to consumers: What benefits are covered? (E.g., are they limited to diagnosis and treatment, or do they also include preventive care? Are experimental services excluded? Does the definition recognize and mandate the…
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July 23, 2013
Consumer-Oriented Approaches to Problem Solving in Medicaid Managed Care
Jane Perkins Issue Brief
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July 23, 2013
NHeLP Comments: Medicare + Choice Interim Final Regulations Pertaining to Repro
dfitzgerald Comments
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July 23, 2013
New Childhood Lead Poisoning Report Issued (Jan. ’99)
External Source Manual/Report
The General Accounting Office has just issued another report that concludes that federal health programs are not effectively serving children at risk for lead poisoning: Lead Poisoning: Federal Health Care Programs Are Not Effectively Reaching At-Risk Children. The findings of the report add to those of a February…
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Model Medicaid Managed Care Contract Provisions — Member Advocates

Model Medicaid Managed Care Contract Provisions — A Primer on Medicaid Managed

Model Medicaid Managed Care Contract Provisions — Medical Necessity Definition

Consumer-Oriented Approaches to Problem Solving in Medicaid Managed Care

NHeLP Comments: Medicare + Choice Interim Final Regulations Pertaining to Repro

New Childhood Lead Poisoning Report Issued (Jan. ’99)