Medicaid, Medical Loss Ratio

[Webinar] Final Medicaid Rules, Part Two: Managed Care Payments, Quality and Oversight - May 21st, 12:00 pm - 1:00 pm PT

Manatt, Phelps & Phillips, LLP on 4/16/2024

This program is part two of Manatt’s New Federal Rules on Medicaid Access and Managed Care webinar series. After releasing sweeping proposed rules on Medicaid access and managed care in spring 2023, the Centers for...more

CMS Proposes Changes to Medicare Advantage and Part D Programs

Manatt, Phelps & Phillips, LLP on 1/25/2022

On January 12, the Centers for Medicare & Medicaid Services (CMS) released the Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs proposed rule,...more

Day One Notes for the 40th Annual J.P. Morgan Healthcare Conference, 2022

Sheppard Mullin Richter & Hampton LLP on 1/12/2022

For those of you who know me, I like to have fun with my Zoom backgrounds – choosing photos of interesting scenery or changing them mid-call to reflect my mood or negotiating strategy. Sitting in front of my computer this...more

OIG Report Examines Minimum Loss Ratio Impact on South Carolina Medicaid Managed Care

King & Spalding on 1/9/2017

OIG recently issued a report determining that South Carolina’s Medicaid Managed Care program would not have realized any savings if the state agency implemented a minimum Medical Loss Ratio (MLR) similar to the current...more

Manatt on Medicaid: CMS Dramatically Expands Guidance on MMC Plan Payment

Manatt, Phelps & Phillips, LLP on 6/17/2016

Editor's Note: This "Manatt on Medicaid" is the sixth in a series of updates focused on CMS's new Medicaid/CHIP managed care regulations. In the coming weeks, Manatt will continue to explore key provisions of the regulations...more

CMS’s Final Medicaid Rule Tweaks the Proposed Rules Related to Marketing, Physician Incentive Arrangements and Long-term Care

McDermott Will & Emery on 5/26/2016

On April 25, 2016, the Centers for Medicare & Medicaid Services (CMS), released the Medicaid managed care final rule entitled, “Medicaid and Children’s Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP...more

CMS’s Final Medicaid Rule Creates a Medicaid MLR Framework but Leaves Room for State Variation

McDermott Will & Emery on 5/12/2016

In Depth - The final Medicaid managed care rule issued by the Centers for Medicare & Medicaid Services (CMS) on April 25, 2016, (the Final Rule) establishes a new federal medical loss ratio (MLR) standard for Medicaid...more

Medicaid and CHIP Managed Care Final Rule: It’s All About Consistency

BakerHostetler on 5/10/2016

The Centers for Medicare & Medicaid Services (CMS) recently issued a 1,425-page regulation (Rule) on managed care in Medicaid and the Children’s Health Insurance Program (CHIP), dubbed the first overhaul of these regulations...more

CMS Issues Final Rule for Medicaid and CHIP Managed Care

King & Spalding on 5/5/2016

On April 25, 2016, CMS released a Final Rule that will update regulations governing Medicaid and Children’s Health Insurance Program (“CHIP”) managed care plans. This Final Rule is the first major update to the Medicaid and...more

CMS Increases Oversight of Medicaid Managed Care Contracts

Mintz - Health Care Viewpoints on 4/29/2016

As noted in a post published yesterday, CMS issued the final rule regarding Medicaid managed care earlier this week. With this rule, CMS is taking a much more active role in overseeing states’ Medicaid managed care...more

A&B Healthcare Week In Review, September 2015

Alston & Bird on 10/1/2015

On September 25, 2015, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule entitled “Medicare Program: Medicare Clinical Diagnostic Laboratory Tests Payment System”. This proposed rule would...more

CMS Proposes Overhaul of Medicaid and CHIP Managed Care Rules

Manatt, Phelps & Phillips, LLP on 6/13/2015

On May 26, 2015, the Centers for Medicare and Medicaid Services (CMS) released a notice of proposed rulemaking (NPRM) to overhaul the regulations governing Medicaid managed care and make conforming changes to the rules that...more

Medicaid Managed Care Update: CMS Proposes a National Medicaid MLR Standard

McDermott Will & Emery on 6/11/2015

States would have the option to create binding Medicaid MLR requirements modeled after existing commercial market MLR standards. This article is part of a series that takes an in-depth look at several proposals that...more

Medicaid Managed Care Update: CMS Proposes Broad-Reaching Reforms to Modernize Medicaid Managed Care

McDermott Will & Emery on 6/11/2015

The proposals strive to balance increased federal government oversight and administration with continued recognition of, and flexibility for, state managed care programs. This is the first article in a series that takes...more

Proposed Rule's Medicaid Managed Care Medical Loss Ratio Requirement Will Likely Impact Plans, Providers and Patients in New York

Proskauer Rose LLP on 6/4/2015

On June 1, 2015, the Department of Health and Human Services Center for Medicaid and Medicare Services (CMS) published a proposed rule at 80 Fed. Reg. 31097 (Proposed Rule) that will fundamentally change state Medicaid...more

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