The Obama administration released new rules last week of Medicaid managed care programs, the first rules update in over a decade. The rules apply to the private insurers who primarily manage long-term care in numerous states. They include a concept that Obamacare applies to private insurance companies which is being universally panned by the companies who provide Medicaid managed care in various states: the medical loss ratio (MLR) which mandates insurers spend between 80 and 85 percent of premiums on health care versus administrative expenses. Medicare has an MLR for private Advantage and Part D plans, but Medicaid managed care was about the only area of the private insurance market untouched by a national MLR.
Health Insurers Not Happy With New Medicaid Managed Care rules
rss@dailykos.com (Joan McCarter), Daily Kos
Mon, 06/01/2015 - 5:00pm
BING NEWS:
- Millions Were Booted From Medicaid. The Insurers That Run It Gained Medicaid Revenue Anyway.
Private Medicaid health plans lost millions of members in the past year, but at least two of the five largest publicly traded companies selling plans have continued to increase revenue from the ...
05/3/2024 - 2:03 am | View Link - How Oklahoma’s transition to managed Medicaid happened and what’s next
The transition to managed Medicaid has been decades in the making. StateImpact’s Jillian Taylor spoke with Lou Carmichael, the CEO of Variety Care, about how it all happened.
05/2/2024 - 3:25 pm | View Link - CMS Finalizes Sweeping Regulations for Medicaid Access, Managed Care, and HCBS
These final rules represent the most significant changes to federal Medicaid and CHIP regulations since CMS established the existing regulatory framework for managed care in 2016. These changes are ...
05/2/2024 - 1:00 pm | View Link - Unnecessary insurance claim denials compromise patient care and provider bottom lines
Nearly 15% of all claims submitted to payers for reimbursement were initially denied. More than half were eventually overturned and paid.
04/30/2024 - 9:30 pm | View Link - Medicaid disclosure unfairly benefits Aetna, rival insurers say
The insurer may have received a sneak peek into how competitors structured their bids to run Texas’ $116 billion Medicaid managed care program.
04/29/2024 - 10:00 pm | View Link - More
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