The Medicaid Managed Care Rule (Final Rule) finalizes several new and updated standards to support and improve managed care accessibility, finance, and quality in Medicaid and the Children’s Health Insurance Program (CHIP). Recently released by the Centers for Medicare & Medicaid Services (CMS), the revised standards represent a significant step in aligning the Medicaid and CHIP managed care rules with regulatory changes in the private market and the Medicare Advantage program. In a companion blog post, we analyzed the funding and transparency changes to state-directed payments (SDPs) in the Final Rule. In this blog post, we address the standards finalized by CMS for timely access to care, in lieu of services and settings (ILOSs), medical loss ratio (MLR), and a new quality ratings system for Medicaid and CHIP managed care plans.
Read the full article, “Medicaid and CHIP Managed Care Final Rule: But wait, there is more.”