Do We Need More Regulation

Medicaid Plans Get New Quality and Performance Measures

CMS announced a proposal Tuesday to "modernize the Medicaid managed care regulations," which haven't been revised in a decade.

"The proposed rule would align the rules governing Medicaid managed care with those of other major sources of coverage, including coverage through Qualified Health Plans and Medicare Advantage plans," according to a CMS statement.

Most managed care plans offer health benefits and other services through contracts between state agencies and managed care organizations (MCOs). States set up and supervise their own managed care programs within the boundaries of federal requirements spelled out in Medicaid law and additional regulations. They also receive a fixed monthly payment for each enrolled Medicaid beneficiary.