CMS issues updated guide to Medicaid managed care contract review

The Centers for Medicare & Medicaid Services yesterday released for states submitting Medicaid managed care contracts for review. The guide incorporates changes included in the 2020 Medicaid and Children鈥檚 Health Insurance Program managed care final rule pertaining to pass-through payments, state-directed payments, network adequacy standards, risk sharing mechanisms, appeals and grievances, and requirements for beneficiary information. It also covers standards used to review and approve state Medicaid contracts with prepaid inpatient and ambulatory health plans, primary care case management entities and health insuring organizations.
Related News Articles
Headline
Rep. Mariannette Miller-Meeks, R-Iowa, participated in a fireside chat during the afternoon plenary session today at the 2025 AHA Annual Membership meeting. As鈥�
Headline
Rep. Robin Kelly, D-Ill., member of the Health Subcommittee of the Energy and Commerce Committee and chair of the Congressional Black Caucus Health Braintrust鈥�
Headline
The AHA has released several resources that can be used to educate members of Congress and community stakeholders about the potential effects of harmful cuts鈥�
Perspective
The House Energy & Commerce Committee in just over a week is expected to mark up its portion of the budget reconciliation bill to enact key pieces of鈥�
Headline
A study published April 28 by Health Affairs Scholar found low-income adults living in states with Medicaid expansion experienced an average 9.5% relative鈥�
Headline
The AHA April 30 released a report highlighting how hospitals and health systems continue to experience significant financial headwinds that can challenge鈥�