CMS issues updated guide to Medicaid managed care contract review

The Centers for Medicare & Medicaid Services yesterday released updated guidance for states submitting Medicaid managed care contracts for review. The guide incorporates changes included in the 2020 Medicaid and Children’s Health Insurance Program managed care final rule pertaining to pass-through payments, state-directed payments, network adequacy standards, risk sharing mechanisms, appeals and grievances, and requirements for beneficiary information. It also covers standards used to review and approve state Medicaid contracts with prepaid inpatient and ambulatory health plans, primary care case management entities and health insuring organizations.
Related News Articles
Headline
A bipartisan House letter by Reps. Dan Crenshaw, R-Texas, Yvette D. Clarke, D-N.Y., Gus M. Bilirakis, R-Fla., and Diana DeGette, D-Colo., urged House…
Headline
The AHA detailed its key health care priorities for the remainder of the year in comments to House and Senate majority and minority leaders Sept. 15. The AHA…
Headline
The Centers for Medicare & Medicaid Services Sept. 9 issued preliminary guidance regarding the implementation of certain state-directed payment provisions…
Headline
The AHA and other national hospital organizations Sept. 5 urged Senate and House leadership to act on preventing Medicaid Disproportionate Share Hospital…
Headline
The Department of Health and Human Services and the Centers for Medicare & Medicaid Services Aug. 21 announced the creation of a Healthcare Advisory…
Headline
The Centers for Medicare & Medicaid Services today announced a nationwide initiative aimed at reinforcing eligibility standards for Medicaid and the…