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- July 23, 2013
Medicaid Managed Care Monitoring Tool 2: Your Legal Rights Brochure
Read moreMost families in your area who get Medicaid are in a "managed care" plan. This means that you have a primary care provider, and you must go to the primary care provider for your care. Some people have found this to be a good program, but some people…
- July 23, 2013
Medicaid Managed Care Monitoring Tool 1: Client Questionnaire
Read moreAlong with Legal Services of Southern Piedmont, the National Health Law Program drafted this Medicaid managed care questionnaire. We have found ready use for these documents in legal aid waiting rooms, for surveying clients at public meetings, and while they wait at department of social services offices. This questionnaire…
- July 23, 2013
Medicaid Managed Care Contracts: An Advocacy Checklist for People with Disabili
Read moreMedicaid Managed Care Contracts: An Advocacy Checklist for People with Disabilities The managed care contracts between the state Medicaid agency and managed care organizations have become a new and significant legal document. In business law, the period during which the parties review a contract and investigate characteristics of the…
- July 23, 2013
Model Medicaid Managed Care Contract Provisions — Third Party Beneficiaries
Read moreNHeLP Model Medicaid recipients enrolled in managed care are the intended third-party beneficiaries of contracts between the state and MCOs and of any subcontracts or provider agreements entered into by MCOs with subcontracting providers and, as such, enrollees are entitled to the remedies accorded to…
- July 23, 2013
Model Medicaid Managed Care Contract Provisions — Member Advocates
Read moreNHeLP 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…
- July 23, 2013
Model Medicaid Managed Care Contract Provisions — A Primer on Medicaid Managed
Read moreBrief Introduction to Medicaid Managed Care Contracting To 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…