Medicaid Case Management Policy Reform to Promote Healthy Child Development


Medicaid, which serves a disproportionate share of high-risk and disabled children, has long covered supportive services not typically covered by private insurance. Of these, care coordination is especially valuable, helping families of children with developmental delays or chronic health problems access services and enhancing communication among their multiple providers. In an effort to reduce the billions of dollars Medicaid spends on case management—as targeted care coordination is known—recent federal policies have severely limited both eligibility for care coordination and the scope of services that qualify for reimbursement. States are unclear how to interpret and apply these policies, however. In the absence of clear federal guidance, states are preemptively scaling back services for fear of incurring financial penalties. This project will review and analyze existing laws and regulations and make recommendations for their interpretation and improving the efficient and judicious use of publicly funded care coordination services.

Grant Details

Grantee Organization:
The George Washington University
Principal Investigator:
Sara Rosenbaum, J.D.
Award Amount:
Approval Date:
July 15, 2008

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