Medicaid Managed Care Rule: What Advocates Should Know

Recently the Obama administration released new standards governing Medicaid managed care plans. These managed care rules haven’t been updated since 2002, and a lot has changed in the past 14 years. There are currently over 72 million people enrolled in Medicaid, and three-quarters are enrolled in managed care.

The new requirements will affect enrollment, network adequacy, beneficiary support, and more.  In three short analyses, we explain what impact these requirements will have on patients—and flag opportunities for health care advocates to get involved in implementing the changes.

Different sections of the rule will go into full effect at different times. The following analyses contain more information on timelines and dig into the details of the new standards:

• Changes to the Medicaid Managed Care Enrollment Process
• Quality Ratings for Health Care and Standards for Payment and Delivery Reform
• Changes Affecting Access to Health Care and Provider Network Adequacy

Additional Resources:

• Blog: Four Provisions to Watch in the New Medicaid Managed Care Rule
• Webinar: Deep Dive: New Medicaid Managed Care Rule