Managed Care Archive

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  • Advocates’ Guide to Accessibility in Medicaid Managed Care Grievances and Appeal

    Pursuant to new regulations from the U.S. Department of Health and Human Services (HHS), state Medicaid agencies are now required to ensure that managed care plans in each state are complying with new procedural requirements for grievance and appeals systems. This Advocate's Guide from Disability Rights Education and Defense…

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  • NHeLP Urges HHS to Reject Plan to Weaken Medicaid Equal Access Provisions

    National Health Law Program in comments to the U.S. Department of Health and Human Services urges the rejection of a plan being pushed by Centers for Medicare & Medicaid Services Administrator Seema Verma to weaken Medicaid regulations intended to ensure that CMS is enforcing "access to covered services in…

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  • Issue Brief 7: Medicaid Managed Care Final Regulations: BSS

    Senior Attorney Elizabeth Edwards provides analysis and guidance on the updated rule regarding managed care plans in Medicaid, and how it relates to new requirements around beneficiary support systems (BSS). Edwards explains that the updated rule, adopted this year by the U.S. Department of of Health and Human Services…

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  • Issue Brief: A Primer on Reference Pricing & VBID

    Cost sharing is too often a tool that prevents low-income individuals from being able to access quality and timely health care services. Health care experts, however, are exploring other mechanisms, such as Value-Based Insurance Design (VBID) and its Reference Pricing ways to address shortcomings of cost sharing. VBID, at…

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  • NHeLP Comments to PERM Regulations

    Leo Cuello

    In comments to the U.S. Department of Health and Human Services, NHeLP Director of Health Policy Leonardo Cuello recommends that HHS should make the Payment Error Rate Measurement regulations consistent with the recently released Medicaid managed care regulations and use the Payment Error Rate Measurement process as a tool to promote…

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  • NHeLP Comments to MACRA Regulations

    Leo Cuello

    In comments to the U.S. Department of Health and Human Services, NHeLP Director of Health Policy Leonardo Cuello recommends that HHS should improve the Medicare and CHIP Reauthorization Act regulations to encourage models of care that will provide consumers with high-quality care, and put less emphasis only on increasing provider risk…

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