Improving Systems
By Martha Heberlein States may choose to adopt managed care in Medicaid for a number of reasons. For example, they may be interested in improving care management and coordination. Others may wish to gain more predictability in spending or increase accountability for access to providers and quality of care. No matter what the reason (or […]
As policymakers across the country look to balance their budgets, some are turning to Medicaid, recycling the same harmful policies they’ve used year-after-year: eliminating coverage for vulnerable Americans, restricting critical benefits like prescription drug coverage, imposing premiums on those who can’t afford them, and slashing already-low provider reimbursement rates. Community Catalyst and Georgetown University Health […]
Last week the Centers for Medicare and Medicaid Services sent a letter to the Florida Agency for Health Care Administration in response to the state’s request for waiver authority to expand managed care statewide. CMS responded by saying that their Medicaid waiver extension request cannot be granted because it lacks a specific plan. The state’s […]
Medicaid is a critical part of Florida’s health care system. It covers about 27% of the state’s children, pays for 51% of all deliveries and nearly 66% of nursing home days. In 2006, a five-year pilot program replaced traditional Medicaid with an unusual managed-care model and other features that required a Section 1115 waiver from […]
Florida’s 2011 Managed Care Legislation, HB 7107, established “Medicaid Managed Care,” a new statewide managed care program for all covered services. Two separate components are anticipated for the new program: the Florida Long-Term Care Managed Care program, slated for implementation first, and the Florida Managed Medical Assistance program, an expansion of the Medicaid pilot program […]
By Joel Ferber, Legal Services of Eastern Missouri and nationally recognized expert on Medicaid A recent article in USA Today focused on Medicaid managed care and its implications for health reform. Health insurance companies are clamoring for the substantial new business that will become available when Medicaid coverage is expanded to an estimated 16 million […]
