Provider Networks and Access in Medicaid Managed Care: A Look at Federal and State Standards

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To ensure people enrolled in Medicaid managed care plans have appropriate access to health services, the Centers for Medicare and Medicaid Services issued updated federal regulations in 2016. Key elements of these regulations began taking effect in July 2018.

In a new post on To the Point, George Washington University’s Sara Rosenbaum and colleagues look at how these rules govern state standards for travel times to physician offices, provider–patient ratios, cultural competency, and more. The authors also discuss whether the rules represent a major departure from practice or simply reflect states’ current managed care contract provisions.

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