Managed Care Archive

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  • NHeLP Comments on New Mexico Centennial Care 2.0 SMI Amendment

    In this application, New Mexico seeks to waive the Institutes for Mental Disease (IMD) exclusion, implement High Fidelity Wraparound Services for an initially limited group of children and youth, institute a Graduate Medical Education Program, and establish vaccine coverage for limited beneficiary categories. For a variety of reasons, NHeLP…

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  • Florida Maternal and Child Health Fact Sheet

    This fact sheet reports data from several sources that measure Medicaid managed care health care delivery and quality pertaining to maternal and child health. They highlight and summarize information from the state's External Quality Review Report, measures from the Healthcare Effectiveness Data and Information Set (HEDIS), results from the…

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  • Ohio Maternal and Child Health Fact Sheet

    This fact sheet reports data from several sources that measure Medicaid managed care health care delivery and quality pertaining to maternal and child health. They highlight and summarize information from the state's External Quality Review Report, measures from the Healthcare Effectiveness Data and Information Set (HEDIS), results from the…

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  • Finding and Analyzing Medicaid Quality Measures

    This brief provides tools to find the major sources of state and plan-level Medicaid quality data, to learn how to evaluate and compare results, and to use those skills to improve data transparency and to push your state to hold plans accountable to their mission: to manage care effectively…

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  • NHeLP Comments on HHS Regulations Rule (aka SUNSET Rule)

    In the Regulations Rule, HHS seeks to retroactively impose a mandatory expiration date on an estimated 18,000 duly promulgated regulations. Even long-standing rules would be automatically rescinded unless they survive a complex process of assessment and review. Programs like Medicaid and the Children's Health Insurance Program (CHIP) could be…

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  • California Policy Needs During COVID and Beyond: Due Process

    Medi-Cal is a lifeline for Californians during the COVID-19 public health emergency (PHE). Among the many crucial benefits of Medi-Cal, beneficiaries have strong due process protections including the right to written notices, an appeal of denials, and a hearing. These protections ensure that beneficiaries have meaningful rights to challenge…

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