Excellent review on the race to implement managed care in many states by
the Kaiser Foundation.

“Advocates Urge More Government Oversight Of Medicaid Managed Care”


In sum: oversight and monitoring is important for Medicaid managed care, yet every
state is allowed to implement it differently.  There’s a push for standardization from
both advocates and health plans (MCOs) to simplify things and hold the entire system
accountable to benchmark best practices.  Some states (Kansas for example) have
passed legislation that defines quality and this will help them to hold all players in the
system accountable.

We all know that on the federal level, CMS does not have a good track record at
providing oversight and monitoring of states in their implementation of Medicaid
managed care. Reports reveal that CMS needs to provide better guidance/monitoring
on how states set rates for health plans and that CMS has not adequately enforced
a requirement for states to collect data on services provided by Medicaid health plans.

Tony Paulauski
Executive Director
The Arc of Illinois
20901 S. LaGrange Rd. Suite 209
Frankfort, IL 60423
815-464-1832 (OFFICE)
815-464-1832 (CELL)