Medicaid managed care

Latest Headlines

Latest Headlines

Proposed MCO rule would subject Medicaid managed care plans to quality ratings

The Centers for Medicare & Medicaid Services wants to bring quality ratings to Medicaid managed care organizations.

MCO rule under fire for introducing medical loss ratio

The  Centers for Medicare & Medicaid Services released its proposed rule to update Medicaid managed care organization regulations yesterday, and the rule is already under fire for proposing a medical loss ratio of 85 percent for managed care plans.

CMS updates Medicaid managed care organization rules

The Centers for Medicare & Medicaid Services has released its long-awaited  proposed rule that updates its Medicaid managed care organization regulations.

What to expect from the Medicaid managed care proposal

The federal government will soon propose new regulations to  Medicaid managed care rules for the first time since 2002. The Centers for Medicare & Medicaid Services--which has been working on updating the regulations for more than a year--plans to address beneficiary information, provider network requirements and how plans spend money they receive from the program.

CMS to tighten Medicaid managed care organization regulations

Forthcoming rules from the Centers for Medicare & Medicaid Services should strike a better balance between the services offered by Medicaid managed care organizations and the operating profits of the private insurers that offer MCO services.

Iowa Medicaid privatization plan pits savings against services

Iowa's plan to privatize its $4 billion Medicaid program is raising larger questions about whether steering beneficiaries to managed care companies is about improving their health or simply saving the state money.

Report: Medicaid enrollees experience limited access to care

State standards for access to care for those enrolled in Medicaid managed care programs varies greatly, according to a new  report from the Office of the Inspector General.

GAO: Medicaid managed care needs better watchdogs

Improper payments cost Medicaid about $14.4 billion last year, and some of that loss may be due to a gap in managed care program oversight at state and federal levels, according to a report by the Government Accountability Office.

Dispute continues between Anthem Blue Cross, California children's hospital

A dispute between Children's Hospital Central California and WellPoint's Anthem Blue Cross began in 2007 and 2008, when the two organizations were trying to craft a new contract, according to Healthcare Payer News.

Managed care continues to spark debate

The jury is still out on whether managed care companies can provide quality care and cost savings, reported Kaiser Health News and the St. Louis Dispatch.