California Healthline: CMS Studying Medicaid Managed Care Plan Rates, Drafting New Rule

CMS has unveiled details on two initiatives — an actuarial study and a new regulation — that are likely to alter how Medicaid managed care providers and plans operate and how they are paid, Modern Healthcare reports.

The District of Columbia and 37 states currently contract with Medicaid plans, according to Medicaid Health Plans of America. In 2012, the contracts generated revenues totaling nearly $78 billion. Nearly all of the estimated five million U.S. residents who enrolled in Medicaid during the 2014 open enrollment period under the Affordable Care Act are in managed care plans.

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