The use of managed care shifts responsibility and accountability from states to managed care organizations. It also allows states to limit access to a network of providers under contract to a managed care organization. This session discusses oversight of network adequacy and access to care, and how states and the federal government document, monitor, and enforce program standards.
This presentation includes information on managed care network oversight based on a review of publicly available information from 14 state Medicaid programs, including state quality strategies, managed care contracts, and network adequacy standards.
Publication Type: Presentations