Reducing racial care disparities and promoting health equity are key functions of Medicaid managed care organizations, particularly in the context of the coronavirus pandemic, an issue brief from...
Although children enrolled in Medicaid managed care plans increased over the past seventeen years, children’s preventative care rates still fall short of the Centers for Medicare and Medicaid...
Aetna has challenged Oklahoma’s picks for its Medicaid managed care program, SoonerSelect, stating that there were flaws in the bid review process.
“Aetna understands and appreciates the...
Given the positive social determinants of health impacts that Medicaid managed care organizations have achieved in Medicaid programs, policymakers should offer them greater flexibility to maximize that...
Oklahoma has officially chosen four Medicaid contracts for its Medicaid managed care program known as SoonerSelect, according to state healthcare officials.
The state chose Centene, UnitedHealthcare,...
To streamline care and improve quality monitoring, a new AHIP report calls for the expansion of states that contract with managed care organizations (MCO) to deliver Medicaid long-term services and...
States may need to re-evaluate their Medicaid managed care organization payment rates as trends of increased enrollment and low care utilization continue into fiscal year 2021, according to a Kaiser...
New CMS regulations around Medicaid managed care include several major changes regarding network adequacy, beneficiary protection, quality, and payment, according to the Kaiser Family Foundation...
The Department of Health and Human Services has released its finalized rebate rule which changes safe harbors around prescription drug pricing, impacting Medicare Part D plans and certain Medicaid...
The coronavirus pandemic has forced social determinants of health even further into the spotlight and Medicaid programs have responded to the increasing demands with innovative solutions, a Manatt...
Louisiana Department of Health will issue a new request for proposals (RFP) for Medicaid managed care organization contracts, ending a bitter legal battle over the 2019 RFP process, the department...
At the beginning of the coronavirus outbreak, many healthcare organizations halted elective procedures. While this helped increase hospital capacity for patients with coronavirus, it also took a...
North Carolina’s legislature has decided to put off Medicaid expansion for another year, but passed a Medicaid transformation bill to continue the transition from fee-for-service to privatized...
Medicaid managed care plans are innovating telehealth solutions and telehealth coverage, addressing social determinants of health, and improving access to care and informed provider selection for...
Researchers from both coasts of the US collaborated to recommend a special needs plan under Medicare Advantage that would improve the nation’s homeless healthcare strategy.
Individuals facing...
Managed care organizations are providing Medicaid programs with lower cost prescription drugs, resulting in as much as $6.5 billion in net savings in fiscal year 2018, according to a recent report by...
Handling Medicaid beneficiary communication can be a complex undertaking, more challenging than what payers face with most employer sponsored health plan members. But new insight from Adaptation...
The Centene-WellCare merger has changed Georgia’s Medicaid managed care landscape, giving Centene-WellCare the majority of the state’s Medicaid business.
The merger placed Centene-WellCare...
CMS has issued guidance that will help states avoid pursuing a duplicate discount from manufacturers when submitting state Medicaid rebate requests.
“Manufacturers are not required to both...
Food insecurity is one of the biggest social determinants of health. It affects over 19 percent of United States adults, according to data from the Centers for Disease Control and Prevention.
The...
