Feds Unveil Long-Awaited Overhaul of Medicaid Managed Care

The federal government on Tuesday unveiled a long-awaited regulatory package that sets national standards for managed care under Medicaid, marking the biggest changes to the growing program in more than a decade.

The nearly 700-page rule, described by some groups as an “uber rule,” contains instructions about what state Medicaid programs must do when hiring private health plans to handle long-term care for the elderly and disabled – also known as managed care.

The Centers for Medicare and Medicare Services (CMS) is proposing that Medicaid managed care groups align their standards with those in the private marketplace to create more uniform practices across states.

Those changes will help to “ease the administrative burden on issuers and regulators” while also providing “an appropriate level of protection for enrollees,” CMS wrote in the rules.