Managed Care

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September 30, 2014
Lessons from CA: Contraceptive Coverage
dfitzgerald Issue Brief
In this month's Lessons from California, we highlight landmark legislation, the Contraceptive Coverage Equity Act (SB 1053, Mitchell), the state just enacted that requires that Medi-Cal managed care organizations (MCO) and most private insurers cover all FDA-approved methods and strictly limits MCO medical management techniques. These important new state…
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September 29, 2014
County Organized Health System Medi-Cal Plans
dfitzgerald Issue Brief
In certain counties, Medi-Cal managed care is operated by a single County Organized Health System (COHS). In COHS counties, a single plan serves all Medi-Cal beneficiaries who are enrolled in managed care. Unlike other Medi-Cal managed care plans, COHS plans are not required to obtain Knox Keene licensure for…
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September 19, 2014
Health Advocate: Medicaid Managed Care: Modernized Federal Regulations are Long
Sarah Somers Health Advocate
In 1965, when the Medicaid program was created, American health care bore little resemblance to the complex system we have today. One of the most significant changes has been the expanding role of managed care. In its early years, Medicaid was almost exclusively a fee-for-service system in which providers…
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September 17, 2014
Medicaid Managed Care Model Provisions, Issue 4
Mara Youdelman, Elizabeth Edwards, and dfitzgerald Issue Brief
Our new Medicaid Managed Care Model Provisions Series features our set of modernized model federal regulations. Each issue provides model provisions addressing problems that policymakers and advocates may use when updating existing regulations, policies and managed care contracts. In this issue, we address accessibility and language access.
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September 17, 2014
Medicaid Managed Care Model Provisions, Issue 3
Abbi Coursolle and dfitzgerald Issue Brief
Our new Medicaid Managed Care Model Provisions Series features our set of modernized model federal regulations. Each issue provides model provisions addressing problems that policymakers and advocates may use when updating existing regulations, policies and managed care contracts. In this issue, we address network adequacy.
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September 17, 2014
Medicaid Managed Care Model Provisions, Issue 2
dfitzgerald Issue Brief
Our new Medicaid Managed Care Model Provisions Series features our set of modernized model federal regulations. Each issue provides model provisions addressing problems that policymakers and advocates may use when updating existing regulations, policies and managed care contracts. In this issue, we address enrollment and disenrollment rights.
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