This year, the Centers for Medicare & Medicaid Services (CMS) finalized the first overhaul of Medicaid and the Children's Health Insurance Program (CHIP) regulations in more than a decade. The new Medicaid managed care rule revises the program's regulatory framework with extensive impacts for managed Medicaid plans across the United States. The provisions of this new rule, titled Medicaid and Children's Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in Managed Care, and Revisions Related to Third Party Liability CMS-2390-F), will be implemented in phases over three years, starting July 1, 2017.
This white paper explores some of the key provisions in this extensive regulation that will create new administrative challenges for managed Medicaid plans and help plans begin identifying the steps necessary to meet the complexity of the new requirements as they are phased in.
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