HHS Issues Major Rule Modernizing Medicaid Managed Care

The U.S. Department of Health and Human Services (HHS) recently issued theMedicaid and Children’s Health Insurance Program (CHIP) Managed Care Final Rule which updates how Medicaid works for nearly two-thirds of the 72 million beneficiaries enrolled in Medicaid managed care plans.

Primary goals of the final rule:

Support states’ efforts to advance delivery system reform and improvements in quality of care for Medicaid and CHIP beneficiaries;
Strengthen delivery of managed long term services and supports;
Improve the consumer experience of care and key consumer protections;
Align rules across types of health insurance to improve efficiency and help consumers who are transitioning between insurance type; and
Increase program integrity by improving accountability and transparency.

This final rule is the first major update to Medicaid and CHIP managed care regulations in over a decade. The provisions of the rule will be implemented in phases over the next three years, starting on July 1, 2017.

Read the full HHS press release.

Fact Sheets:

Modernizing Medicaid and CHIP Managed Care

Improving the Quality of Care for Medicaid Beneficiaries

Strengthening the Consumer Experience

Strengthening the Delivery of Managed Long Term Services and Supports

Additional Resources:

Read the final rule: Medicaid Managed Care (CMS-2390-F). On 05/06/2016 will available online at the Federal Register

Additional facts sheets