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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.
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.
CMS Proposes Changes to Streamline and Strengthen Medicaid ...
Proposed Rule Continues Commitment to Promote Flexibility, Strengthen Accountability, and Maintain and Enhance Program Integrity in Medicaid and CHIP. Today, the Centers for Medicare & Medicaid Services (CMS) is proposing significant regulatory revisions to streamline the 2016 managed care regulatory framework.
Notice of Proposed Rulemaking (NPRM); Medicaid Program ...
Notice of Proposed Rulemaking (NPRM); Medicaid Program; Medicaid and Children’s Health Insurance Program (CHIP) Managed Care (CMS-2408-P) In 2016, CMS issued a final rule that was a comprehensive rewrite of the Medicaid and CHIP managed care regulations to better align managed care rules with other health care coverage programs.
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]
100-16 | CMS - Centers for Medicare and Medicaid Services
Medicare Managed Care Manual. Downloads. Chapter 1 - General Provisions (PDF) ... 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] ... Receive Email Updates . Connect with CMS. Twitter link.
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.
Regulations & Guidance | 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] ... Receive Email Updates . Connect with CMS. Twitter link.
Managed Care Marketing | CMS
Managed Care Marketing This section includes useful information to help Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, Prescription Drug Plans, and 1876 Cost Plans with marketing efforts. ... The Centers for Medicare & Medicaid Services (CMS) as a part of our agreement to share information and collaborate on oversight ...
Managed Care Authorities | Medicaid
Freedom of Choice: Allows states to require people to receive their Medicaid services from a managed care plan. List of approved managed care waivers. 1932(a) State Plan Basics. States can use a managed care delivery system by getting a state plan amendment approved by CMS.
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