CMS Proposes Changes to Medicaid Managed Care Rules, Including on State Directed Payments

by kara | May 9, 2023 | Medicaid, Medicaid Managed Care

On Thursday, April 27, the Centers for Medicare & Medicaid Services (CMS) issued a long-anticipated proposed rule related to Medicaid and CHIP managed care programs. Of particular importance for many of our clients across the country, CMS continued its practice of...

MACPAC, GAO Recommend Oversight Changes for Managed Care Directed Payments

by keith | Jun 28, 2022 | Medicaid Managed Care

Both The Medicaid and CHIP Access and Payment Commission and the Government Accountability Office have recently published recommendations for increasing transparency of managed care directed payment programs to facilitate closer evaluation of direct payment programs....

CMS Approves California Advancing & Innovating Medi-Cal (CalAIM) Waivers, Including Provisions to Address Social Determinants of Health

by keith | Dec 31, 2021 | Medicaid, Medicaid Managed Care, News and Updates, Waivers

In December, CMS approved some of California’s CalAim proposals through extensions of its 1115 demonstration and 1915(b) managed care waivers. California is transitioning significant programs under its prior 1115 waiver into its 1915(b) waiver, and working to sustain...

CMS Releases Revised Managed Care Directed Payments Preprint Application

by keith | Jan 8, 2021 | Directed Payments, Medicaid Managed Care, Medicaid Managed Page

On January 8, 2021, CMS published a revised managed care directed payment preprint application as part of its new guidance on directed payments released the same day. The revised preprint incorporates additional questions and more detailed tables, many of which had...

CMS Releases New Guidance on Managed Care Directed Payments

by keith | Jan 8, 2021 | Directed Payments, Medicaid Managed Care, Medicaid Managed Page

On January 8, 2021, the Centers for Medicare & Medicaid Services (CMS) issued a State Medicaid Director Letter (SMDL) outlining additional guidance on Medicaid managed care directed payments, as well as a revised preprint form for use in seeking approval of...

CMS Issues Medicaid Managed Care Final Rule

by keith | Nov 9, 2020 | Directed Payments, Medicaid Managed Care, Medicaid Managed Page, News and Updates, Rulemaking

On November 9, 2020, CMS issued a managed care rule that largely finalizes policies proposed by the agency in a November 2018 proposed rule. Among other things, the final rule would eliminate prior approval requirements for directed payments implementing minimum fee...