Medicaid Managed Care Insurers Targeted for Additional Scrutiny

Private health insurance companies that operate Medicaid managed care plans would see greater scrutiny from the Biden administration under a proposal announced Thursday.

The proposed rule (RIN 0938-AU99) from the Centers for Medicare & Medicaid Services would set standards for appointment wait times, require states and managed care organizations to disclose provider payment rates, and establish a “one-stop-shop” on states’ websites so that Medicaid beneficiaries can compare the services provided by different managed care plans.

Under Medicaid managed care, states contract with private insurance companies to deliver health-care services to patients. The Medicaid and CHIP Payment and Access Commission estimates ...