Healthcare DIVE March 18, 2024
Rebecca Pifer

The CMS doesn’t require states to report data on outcomes or care denials, and has made “delayed” progress on plans to analyze the information and make it public, according to the GAO.

Dive Brief:

  • A government watchdog is ringing the alarm on potential quality and access issues in Medicaid managed care, when states contract with private companies to administer the care of Medicaid beneficiaries.
  • Rates of Medicaid beneficiaries appealing care denials and filing grievances vary widely from state to state, which could signal access problems, according to the Government Accountability Office’s review of the first year of data from states’ annual managed care reports.
  • Despite regulators’ efforts to get a clearer view of the data, the GAO found the...

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Topics: CMS, GAO, Govt Agencies, Insurance, Medicaid, Payer, States, Survey / Study, Trends
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