Medicaid Managed Care: Transparency Tips for Advocates

In the world of Medicaid managed care, as Ringo might say, transparency don’t come easy. That is one take-away from a lawsuit filed earlier this week by the Better Government Association (BGA), which describes itself as “Illinois’ non-partisan full-service watchdog,” against the state’s Medicaid agency, the Department of Healthcare and Family Services (HFS), which runs […]

A Guide for Child Health Advocates: Medicaid Managed Care Accountability Through Transparency

Medicaid, Managed Care, and Transparency Medicaid is the nation’s largest health insurer for children—over 35 million at last count—and pays for nearly half of the nation’s births. It offers a comprehensive pediatric benefit—Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services—for children and comprehensive maternity care for pregnant women. In most states, Medicaid agencies contract […]

Advocacy Guide Outlines Strategies for Supporting Primary Care Practitioners in Medicaid Managed Care Networks During Pandemic

The pandemic has not been good for children or their physicians. Well-child and other non-emergency visits are down, so children are missing important screening benchmarks as well as immunizations.  Pediatric practitioners who are paid on a fee-for-service basis have seen their revenues fall and the financial stability of their practices imperiled. The situation has improved […]