Managed Care

Managed Care

Real Protections for Kids and Families in the Newest Texas Medicaid Managed Care Laws

In June 2018, the Dallas Morning News began publishing a series of in-depth investigative reports on Texans harmed through Medicaid managed care, potential conflicts of interest, and weaknesses in oversight and enforcement of Medicaid managed care contracts. The articles resulted in public hearings in the Texas House of Representatives that further explored the issues and allowed the public to comment. In […]

“Pain & Profit:” How Not to Do Medicaid Managed Care

We know that CMS Administrator Seema Verma doesn’t think Medicaid should cover “able-bodied” adults. But she does believe that coverage of the “society’s most vulnerable citizens” is the right thing for Medicaid to do.  In her major policy address to state Medicaid directors last November, she opened with the stories of Richard, a para-pelagic, and […]

Ongoing Advocacy Needed to Ensure Children Covered by Managed Care Plans Receive Medicaid’s Guaranteed Pediatric Benefit

Child health advocates know the importance of five simple but powerful letters in Medicaid: EPSDT or Early and Periodic Screening Diagnostic and Treatment Services. EPSDT – that is, Medicaid’s comprehensive pediatric benefit standard – provides children with preventive and diagnostic services and ALL medically necessary services that can be covered under federal Medicaid law to […]