Managed Health Care Oversight

Listing Websites about Managed Health Care Oversight

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Managed Care HHS-OIG - Office of Inspector General

(4 days ago) WEBThe HHS-OIG Strategic Plan for Oversight of Managed Care for Medicare and Medicaid has three goals: Promote access to care for people enrolled in managed care. Provide comprehensive financial oversight. Promote data accuracy and …

https://oig.hhs.gov/reports-and-publications/featured-topics/managed-care/

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Managed Care Oversight : MACPAC

(8 days ago) WEBIt covers the key elements of managed care oversight, including payment, network adequacy, quality measurement, and reporting, and concludes with an update on the …

https://www.macpac.gov/publication/managed-care-oversight/

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Managed Care Oversight - MACPAC

(6 days ago) WEBOversight approach: Beneficiary protections for vulnerable populations. Individuals with significant or complex health care needs require additional protections …

https://www.macpac.gov/wp-content/uploads/2018/09/Managed-Care-Oversight.pdf

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HHS Provides States with Additional Resources to Improve …

(Just Now) WEBToday, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS) unveiled a suite of new resources …

https://www.hhs.gov/about/news/2022/07/06/hhs-provides-states-with-additional-resources-to-improve-oversight-and-ensure-access-to-quality-care-in-medicaid-and-chip-managed-care-programs.html

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Managed Care Quality Improvement Medicaid

(3 days ago) WEBFederal regulations at 42 CFR 438 subpart E (Quality Measurement and Improvement) require states with managed care contracts to carry out a set of managed care quality …

https://www.medicaid.gov/medicaid/quality-of-care/medicaid-managed-care-quality/managed-care-quality-improvement/index.html

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What is Managed Care? Cigna Healthcare

(9 days ago) WEBThe term “managed care” is used to describe a type of health care focused on helping to reduce costs, while keeping quality of care high. The most common health plans …

https://www.cigna.com/knowledge-center/what-is-managed-care

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MACPAC recommends changes to improve Medicaid managed …

(Just Now) WEBJan 29, 2024 - 04:01 PM. The Medicaid and CHIP Payment and Access Commission (MACPAC) last week recommended seven changes to Medicaid managed care policy …

https://www.aha.org/news/headline/2024-01-29-macpac-recommends-changes-improve-medicaid-managed-care-oversight

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Medicaid Managed Care: OIG, MLRs, and the Future of Oversight

(7 days ago) WEBAs the OIG explains: “States’ oversight of their plans’ annual MLR reporting is critical to improve fiscal transparency, monitor costs, and promote high-quality care in …

https://ccf.georgetown.edu/2022/10/06/medicaid-managed-care-oig-mlrs-and-the-future-of-oversight/

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Managed Care Oversight : MACPAC

(Just Now) WEBThe use of managed care shifts responsibility and accountability from states to managed care organizations. This session will consider the adequacy of managed care …

https://www.macpac.gov/publication/managed-care-oversight-2/

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California Department of Managed Health Care > About Us

(1 days ago) WEBThe Office of Enforcement represents the Department in actions to enforce the managed health care laws. The primary purpose of an enforcement action is to change plan …

https://www.dmhc.ca.gov/AbouttheDMHC.aspx

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Managed Care in Medicaid — Need for Oversight, Accountability, …

(8 days ago) WEBMedicaid spending through managed care has quadrupled after the ACA in inflation-adjusted dollars—up from about $100 billion in 2010 (the year the ACA was …

https://paragoninstitute.org/medicaid/managed-care-in-medicaid-need-for-oversight-accountability-and-reform/

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California Department of Managed Health Care

(4 days ago) WEBMark Ghaly. Secretary, Health & Human Services Agency. View Mark's profile. Mary Watanabe. Director, Department of Managed Health Care. View Mary's profile. Health …

https://www.dmhc.ca.gov/

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Medicaid Managed Care: Improvements Needed to Better Oversee …

(9 days ago) WEBGAO was asked to examine payment risks in Medicaid managed care. In this report, GAO (1) identified payment risks; (2) identified any challenges to state oversight …

https://www.gao.gov/products/gao-18-528

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About Us - California Department of Managed Health Care

(6 days ago) WEBMary Watanabe is the Director of the California Department of Managed Health Care, the state entity that oversees health plans that provide health care services to more than …

https://www.dmhc.ca.gov/AbouttheDMHC/LeadershipTeam.aspx

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Managed Care Regulation - MN Dept. of Health

(4 days ago) WEBThe Managed Care Systems Section has licensing and regulatory oversight on all Health Maintenance Organizations (HMOs) and County-Based Purchasers …

https://www.health.state.mn.us/facilities/insurance/managedcare/index.html

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Department of Health Health Facilities Consumer Reports and …

(Just Now) WEBGuide for adults planning for their future financial, health and housing needs. Describes programs that provide medical, financial, legal, and social service …

https://www.nj.gov/health/healthfacilities/reportcards.shtml

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Managed Care Oversight - Cabinet for Health and Family Services

(8 days ago) WEBManaged Care Oversight - Contract Management Branch. The Contract Compliance Branch provides contract oversight to assure that the Managed Care Organizations …

https://www.chfs.ky.gov/agencies/dms/dpqo/mco-cmb/Pages/default.aspx

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Federal Register :: Medicaid Program; Medicaid and Children's …

(1 days ago) WEBReporting Requirements To Support Oversight and Inclusion of SDPs in MLR Reporting (§§ 438.6(c)(4), and 438.8(e)(2)(iii)(C) and (f)((2)(vii)) health insurers, …

https://www.federalregister.gov/documents/2024/05/10/2024-08085/medicaid-program-medicaid-and-childrens-health-insurance-program-chip-managed-care-access-finance

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Horizon Blue Cross Blue Shield of New Jersey 2017 Managed …

(4 days ago) WEBHorizon Blue Cross Blue Shield of New Jersey 2017 Managed Care Benefits-at-a-Glance1. If you have questions about enrollment, benefits or claims, visit NaviNet.net or …

https://www.horizonblue.com/sites/default/files/2017-04/2017_Managed_Care_Benefits_at_a_Glance_Reference_Guide.pdf

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Key federal program accountability requirements in Medicaid …

(5 days ago) WEBThe requirements related to the federal oversight of full-risk Medicaid managed care programs can be found in Section 1932 of the Social Security Act (the Act) as well as in …

https://www.macpac.gov/subtopic/key-federal-program-accountability-requirements-in-medicaid-managed-care/

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Judge rules Oregon's health care M&A law doesn't violate the

(7 days ago) WEBThe oversight program launched in March 2022, in response to concerns about consolidation in health care leading to increased costs and decreased quality and …

https://www.bizjournals.com/portland/news/2024/05/17/hospital-association-lawsuit-m-a-oversight-health.html

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AHA Statement for Senate Finance Committee Hearing on Rural …

(5 days ago) WEBStatement of theAmerican Hospital Associationfor theCommittee on Financeof theU.S. Senate“Rural Health Care: Supporting Lives and Improving Communities”. May …

https://www.aha.org/testimony/2024-05-16-aha-statement-senate-finance-committee-hearing-rural-health-care

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It's been a year since Arizona's shocking Medicaid fraud - MSN

(Just Now) WEBThe state's Medicaid program is called the Arizona Health Care Cost Containment System (AHCCCS). While Mayes initially estimated the fraud had amounted to "hundreds of …

https://www.msn.com/en-us/news/us/its-been-a-year-since-arizonas-shocking-medicaid-fraud-announcement-what-has-changed/ar-BB1mv7Fj

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U.S. Managed Care Market Report 2024, with Focus on

(8 days ago) WEBThis projection is based on a compound annual growth rate (CAGR) of 5.62% from 2024 to 2028. The segmentation of national health expenditure by source includes …

https://www.globenewswire.com/news-release/2024/05/14/2881412/0/en/U-S-Managed-Care-Market-Report-2024-with-Focus-on-Medicare-Medicaid-and-Private-Health-Insurance.html

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Marquis Health Consulting Services

(2 days ago) WEBA Progressive, Multi-SpecialtyApproach to Healthcare. Marquis Health Consulting Services provides administrative and consulting services to skilled nursing facilities and Senior …

https://mqshealth.com/

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Holsman Healthcare

(3 days ago) WEBTo be your first choice for professional healthcare consulting and rehabilitation services, as we provide the best healthcare professionals for your patient needs. Company Profile . …

http://www.holsmanhealthcare.com/

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Medicaid Managed Care Hospital Networks in Missouri: Too …

(7 days ago) WEBUnited Health Care had 8 hospitals out-of-network in the online provider directory on July 22, 2012. This is double the number they reported in their annual report. oversight of …

https://military.slu.edu/law/health/pdfs/medicaid-managed-care-hospital-networks-mo.pdf

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Despite state bans, abortions nationwide are up, driven by …

(9 days ago) WEBThe report includes abortions happening within the U.S. health care system, and does not include self-managed abortions, when people take pills at home without …

https://www.npr.org/sections/health-shots/2024/05/14/1251086997/abortion-increase-research-wecount-telehealth

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