Tag:

MCO

Finalized Rule: Tough Love for Medicaid MCOs?

Kaitlin Lavin Executive Editor Loyola University Chicago School of Law, JD 2017   Last May, the Centers for Medicare and Medicaid Services (CMS) issued a final rule for Medicaid managed care, which told states to stop making pass-through payments to healthcare providers. Pass-through payments have played a critical role in funding safety net hospitals which …
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The New Medicaid Managed Care Rule and Its Effects on Compliance Programs

Kaitlin Lavin Executive Editor Loyola University Chicago School of Law, JD 2017   The Centers for Medicare and Medicaid Services (CMS) recently published a new rule for state contracts with Medicaid Managed Care Organizations (MCO). Medicaid MCOs provide comprehensive services to beneficiaries for capitated payments. The effective date of the rule was July 5, 2016. …
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