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The report provides basic statistics on Medicaid managed care organizations providing enabling services - transportation, translation, education, and case management. The report also identifies the extent of variation across plans. REPORT Download
Completed for the National Conference of State Legislatures and the Kaiser Commission on Medicaid and the Uninsured, by Health Management Associates. Compiled from Medicaid State Plans and Amendments approved by the Centers for Medicare and Medicaid Services, and from State websites, with verification by State and Territorial Medicaid officials in March 2003.
This policy watch discusses the new opportunities available to states to address health-related social needs through managed care and through Section 1115 demonstration waivers.
This background brief provides a comprehensive look at the appeals process for the Medicaid program, which differs significantly from those available through the Medicare program and private health insurance. The Medicaid appeals process provides redress for individual applicants and beneficiaries seeking eligibility for the program or coverage of prescribed services, but the process is multi-layered and can be complex to navigate. The guide describes Medicaid's appeals system, including the fair hearing process and the appeals…
Results of two surveys that track Californian's knowledge of the two initiatives on the California Ballot, Propositions 214 and 216 (also known as the Patient Protection Acts) and attitudes towards them as the debate unfolds. The surveys were conducted from August 14-21, 1996 and from September 23-30, 1996. Also included with this material is data on how much is being spent on television advertising for and against the propositions and who is being reached by…
Making Medicaid Managed Care Work: An Action Plan for Persons Living with HIV This report, by the National Association of People with AIDS (NAPWA) with support from The Kaiser Family Foundation, describes nine key points for people living with HIV to keep in mind when trying to influence the development of a managed care system that will serve them effectively. Senator John Chafee (R-RI), an acknowledged ally of NAPWA, gratefully accepted the report upon its…
This policy paper describes key requirements of consumer protection regulation under Medicare, Medicaid and federal and state laws as they apply to private health insurance. These include choice and availability of plans, disclosure of information, marketing, access, quality, and the grievance and appeals process. The discussion highlights differences and similarities across public programs and private insurance and compares public and private insurance protection with provisions of the Consumer Bill of Rights (CBRR) developed by the…
An updated study follows trends in commercial health plan participation in Medicaid managed care and includes new analyses on the performance of Medicaid-dominated and commercial plans on measures of effective care and access to care, and on the extent to which plans restrict their Medicaid service areas.
New Data Source on Hospital Use by California's Medi-Cal Enrollees A project sponsored by The Kaiser Family Foundation has resulted in a new source of data that will enhance research on the Medi-Cal program, including the impact of Medi-Cal managed care. The project linked 2 datasets: the Patient Discharge Dataset containing hospital discharge information maintained by the California Office of Statewide Health Planning and Development (OSHPD), and a Medi-Cal dataset containing eligibility and health plan…
This report focuses on Tennessee's experience in moving their disabled Medicaid beneficiaries into managed care.
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