Latest From Andy
Transparency in Medicaid Managed Care: CMS Posts the MCPARs
There’s been a startling—but VERY welcome—development in the long-running MCPAR saga. On July 15, CMCS posted on its medicaid.gov the first three tranches of Managed Care Program Annual Reports (MCPARs) submitted by state Medicaid agencies for performance year 2023. The agency promises to post the remaining tranche for performance year 2023 in October, with quarterly […]
Transparency in Medicaid Managed Care: The MCPAR Saga Continues
Three years ago, the Center for Medicaid & CHIP Services (CMCS) issued an CMCS Informational Bulletin (CIB) on “Medicaid and CHIP Managed Care Monitoring and Oversight Tools.” The CIB triggered a 2016 regulatory requirement that states contracting with managed care organizations (MCOs) submit to CMCS a Managed Care Program Annual Report (MCPAR). The MCPAR contains […]
For-Profit MCOs in Minnesota Medicaid: No More Welcome Mat
Like 41 other states, Minnesota requires most of those enrolled in its Medicaid program to receive services through managed care organizations (MCOs). Unlike most other states, however, Minnesota is in the midst of a policy conversation about whether to move away from managed care toward fee-for-service. In May 2023, the state legislature directed the Medicaid […]
Medicaid Managed Care: Results of the PHE Unwinding for the Big Five in Q1 2024
It’s now been four corporate reporting quarters since the start of the PHE unwinding on April 1, 2023. During that time, net national Medicaid enrollment—the combination of disenrollments from redeterminations, re-enrollment by some of those terminated, and new enrollments—has fallen by 13.1 million, including 5.0 million children. Of the disenrollments, 70 percent have been for […]
A Closer Look at Transparency in the Medicaid Managed Care Rule
The Medicaid Managed Care Rule published on May 10 has lots of moving parts. As my colleague Leo Cuello explains, the rule includes provisions to increase the transparency of state directed payments (SDPs). The rule also contains a number of other transparency requirements that are the focus of this blog, most of which are identical to those […]