Health Payer Intelligence November 25, 2020
The changes do not overhaul Medicaid managed care, but the alterations to network adequacy, beneficiary protection, quality measures, and payment deserve payers’ attention.
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 (KFF).
Most of the changes go into effect on December 14, 2020.
“While the new final rule is not a wholescale revision of the comprehensive 2016 final rule, it does make changes in key areas,” the researchers explained. “Federal rules governing Medicaid managed care are important as managed care remains the predominant care delivery system in most states.”
Under the updated Medicaid managed care regulations, states can use other measures, apart from...
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