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Medicaid managed-care plans face more red tape

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The National Association of Medicaid Directors says that new CMS guidelines meant to ensure the adequate reimbursement of Medicaid managed-care plans will confuse and frustrate state Medicaid agencies while creating too much paperwork for the CMS.


Modern Healthcare reports that “the new rate guidance outlines lengthy data requirements that states must cite so that the CMS is able to determine whether rates are sound. This includes citations to studies, research papers, other states’ analyses, or similar secondary data sources.

“Medicaid directors were taken aback by the {amount and complexity} of the documentation that the agency was requesting.”

“If the agency truly wants to ensure adequate rates, it should work with states and their actuaries to strike a reasonable balance in the level of documentation required and ensure CMS oversight of a feasible rate review process, the association said, ” Modern Healthcare reported.


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