Managed Care Archive

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  • Comments on Proposed Medicaid Managed Care Access Rule

    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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  • [Webinar] Managed Care

    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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  • Trends in State Medicaid Continuous Coverage Unwinding Plans

    As part of the Medicaid continuous coverage unwinding, states were required to create plans to describe how they will redetermine the eligibility of all Medicaid enrollees. This paper identifies some of the major trends affecting beneficiaries in available unwinding plans including choices that may affect coverage loss and ease…

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  • NHeLP Summary of Proposed Access and Managed Care Rules

    Last week, the Centers for Medicare and Medicaid Services (CMS) released two proposed rules intended to improve access to care, quality and health outcomes, and address health equity issues. The first, Medicaid Program: Ensuring Access to Services (Access Rule), addresses in Medicaid fee-for-service, managed care, and HCBS program. The…

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  • What Makes Medicaid, Medicaid?

    With the passage of the Affordable Care Act (ACA) in 2010, and the implementation of Medicaid expansions and Marketplaces in 2014, the U.S. significantly expanded access to health insurance coverage. Architects of the ACA rightly viewed Medicaid as an essential piece of the universal coverage puzzle. Indeed, Medicaid is…

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  • NHeLP Comments on Coverage of Contraceptive Services Under the Affordable Care Act

    Section 2713(a)(4) of the Public Health Service Act, and its implementing regulations, make access to contraception possible by ensuring that health plans in the individual and small group markets adequately cover contraception without cost-sharing—cost-sharing that would otherwise reduce use of this necessary service. In our comments, NHeLP strongly supports…

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