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Medicaid Managed Care Requirements Loosened Under HHS Final Rule

Nov. 9, 2020, 5:50 PM

Medicaid managed care plans will face fewer regulatory burdens and enjoy new flexibility under a final rule announced Monday by the Department of Health and Human Services.

The new rule loosens requirements imposed in 2016 on private Medicaid managed care plans that run the low-income health benefits at a monthly per-person cost to the state. Comprehensive managed care covers 70% of Medicaid enrollees, according to the most recent data from the Centers for Medicare & Medicaid Services. And nearly half of the program’s spending—$300 billion in 2019—goes to the managed care plans.

The 2016 rule drew criticism from Medicaid directors ...