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 […]

American Rescue Plan Offers States Funding to Address Critical Need for Improved Access to Mental Health Services

The American Rescue Plan passed in March included provisions providing states with new funding opportunities to leverage Medicaid to improve access to mental health services. Recent announcements by the Centers for Medicare & Medicaid Services (CMS) provide states with more information about how they can take advantage of the new opportunities. Section 9817 Additional Support […]

Urgent Action Needed to Catch Up on Routine Childhood Vaccinations

Introduction Vaccines are a safe and effective method of reducing the burden of infectious disease. On an individual level, they prevent severe illness, death, and long-term consequences of disease such as neurological disorders. On the community level, they forestall dangerous outbreaks of infectious disease and save money that would otherwise be spent on treating preventable […]

Opportunities to Improve Guidance on Phasing out the Public Health Emergency Continuous Eligibility Provision

In December 2020, the Trump administration issued guidance on unwinding the Medicaid continuous eligibility provision associated with the COVID-19 public health emergency (PHE). There are a number of opportunities for the Biden administration or Congress to strengthen requirements for states to ensure that eligible Medicaid enrollees do not lose coverage at the end of the […]