Managed Care

Managed Care

“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 […]

Protecting and Promoting Medicaid’s Guaranteed Benefits for Children: Iowa EPSDT and Managed Care

Introduction With support from the Georgetown University Center for Children and Families under a Robert Wood Johnson Foundation grant, the Child and Family Policy Center (CFPC, also referred to as the Center) engaged in activities in 2017 to protect and strengthen Medicaid’s critical pediatric benefit in the context of Iowa’s managed care rollout. CFPC welcomed […]

Protecting and Promoting Medicaid’s Guaranteed Benefits for Children: Illinois EPSDT and Managed Care

Introduction In 2017, the Sargent Shriver National Center on Law Poverty and Everthrive Illinois engaged in activities to protect and strengthen Medicaid’s comprehensive and preventive pediatric benefits as more children were enrolled into Managed Care Plans (MCOs). This work was supported by the Georgetown University Center for Children and Families through a grant from the […]