Cms medicaid managed care regulations

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Medicaid and CHIP Managed Care Final Rule | Medicaid

On April 25, 2016, the Centers for Medicare & Medicaid Services (CMS) put on display at the Federal Register the Medicaid and CHIP Managed Care Final Rule, which aligns key rules with those of other health insurance coverage programs, modernizes how states purchase managed care for beneficiaries, and strengthens the consumer experience and key consumer protections.

https://www.medicaid.gov/medicaid/managed-care/guidance/medicaid-and-chip-managed-care-final-rule/index.html 

CMS proposes rule to strengthen managed care for Medicaid ...

CMS proposes rule to strengthen managed care for Medicaid and CHIP Enrollees Proposal will modernize and improve quality of care for Medicaid and CHIP managed care plans ... Since CMS last issued managed care regulations in 2002 and 2003, the health care delivery landscape has changed and grown substantially. ... Get email updates.

https://www.cms.gov/newsroom/press-releases/cms-proposes-rule-strengthen-managed-care-medicaid-and-chip-enrollees 

Additional Guidance | Medicaid

Medicaid Managed Care Marketing Regulations. With the implementation of the Marketplaces, states and managed care plans have been requesting clarification on the marketing regulations at 42 CFR 438.104 and how those regulations may impact marketing activities. To respond to these inquiries, CMS developed this list of Frequently Asked Questions ...

https://www.medicaid.gov/medicaid/managed-care/guidance/additional-guidance/index.html 

Regulations & Guidance | CMS

CMS Advancing Seniors’ Access to Cutting-edge Therapies and Technology in Medicare Hospital Rule Home A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. 7500 Security Boulevard, Baltimore, MD 21244

https://www.cms.gov/Regulations-and-Guidance/Regulations-and-Guidance 

Guidance | Medicaid

This final rule is the first major update to Medicaid and CHIP managed care regulations in more than a decade. View the related blog co-authored by the CMS Administrator and CMCS Director, Medicaid Moving Forward. For questions regarding Managed care, please email [email protected] Other Guidance

https://www.medicaid.gov/medicaid/managed-care/guidance/index.html 

Medicaid Eligibility Quality Control Program | Medicaid

Update: August 17 2020. On April 2, 2020, as a result of the Coronavirus Disease 2019 (COVID-19) public health emergency (PHE), CMS exercised its enforcement discretion to adopt a temporary policy of relaxed enforcement regarding activities related to the Medicaid Eligibility Quality Control (MEQC) program.

https://www.medicaid.gov/medicaid/eligibility/medicaid-eligibility-quality-control-program/index.html 

Managed Care | Medicaid

Managed Care is a health care delivery system organized to manage cost, utilization, and quality. Medicaid managed care provides for the delivery of Medicaid health benefits and additional services through contracted arrangements between state Medicaid agencies and managed care organizations (MCOs) that accept a set per member per month (capitation) payment for these services.

https://www.medicaid.gov/medicaid/managed-care/index.html 

Program of All-Inclusive Care for the Elderly (PACE) | CMS

A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. 7500 Security Boulevard, Baltimore, MD 21244 CMS & HHS Websites [CMS Global Footer] Medicare.gov

https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/PACE/PACE 

Contact CMS | CMS

Contact Information for People with Medicaid Medicaid is a state administered program and each state sets its own guidelines regarding eligibility and services. Please refer to the "Related Links Inside CMS" for a list of State Health Departments.

https://www.cms.gov/About-CMS/Agency-Information/ContactCMS