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Like most states, Nebraska contracts with managed care organizations (MCOs) to deliver covered services to people enrolled in Medicaid. Unlike most states, Nebraska operates a Medicaid Managed Care Excess Profit Fund. Established in 2020, the Excess Profit Fund holds profits that MCOs are required to return to the state, remittances from MCOs in the event […]
Introduction At the end of March 2023, states began the process of redetermining eligibility for more than 90 million Medicaid enrollees after a three-year pause on disenrollment during the COVID-19 pandemic. By December 2023, Medicaid net enrollment had declined by more than 8 million people, including over 4 million children. While a drop in enrollment […]
CMS recently finalized two key regulations: “Ensuring Access to Medicaid Services” (Access Rule) and “Medicaid, CHIP Managed Care Access, Finance, and Quality” (Managed Care Rule), aimed at improving access to care in Medicaid across delivery systems (fee-for-service and managed care) and authorities (state plan and waiver services). The Managed Care Rule addresses five primary areas: […]
Medicaid and CHIP provide health insurance coverage to more than 84 million people, including low-income children, families, seniors, pregnant people, and people with disabilities. While Medicaid has a proven track record of providing affordable, high quality health care, stakeholders have long sought better transparency and accountability with respect to access to services. CMS recently finalized […]
As our nation approaches another sad milestone with nearly 5 million fewer children enrolled in Medicaid, we released a report looking at how states have responded to the challenge of the Medicaid “unwinding” process. With approximately half of the nation’s children enrolled in Medicaid, the stakes are very high for children and the providers who […]
Download the Full Report (PDF) Background During the COVID-19 public health emergency, states received increased federal Medicaid matching rates in exchange for a commitment to maintain continuous coverage for those enrolled in Medicaid. With the public health emergency winding down, as part of the Consolidated Appropriations Act (CAA), 2023, Congress ended the continuous coverage requirement […]
