While its neighbor Iowa cut access to prenatal care, Nebraska invested in new supports for maternal and early childhood health. Nebraska is one of the 37 managed care states with a state Medicaid Medical Loss Ratio (MLR). MLRs help limit public dollars’ support of exorbitant profits for the private, for-profit managed care organizations (MCOs), the […]
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 […]
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 […]
Federal and state leaders have prioritized maternal health in Medicaid in recent years with welcome (if overdue) attention. As Say Ahhh! readers know, the new state option to extend postpartum coverage to 12 months for all pregnant women in Medicaid has been adopted or is in progress in all but two states (AR and WI) […]
