Tag Archives: Medicaid managed care plans

10 tips for working with MCOs to advance Medicaid program integrity

Have you turned to managed care organizations (MCOs) to reduce Medicaid costs and improve patient care? If so, you probably know how difficult it is to know for sure whether your MCOs are doing all they can to reduce fraud, waste and abuse. In May 2015, CMS proposed a new rule that MCOs strengthen their […]
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NCQA member engagement standards change accreditation paradigm for Medicaid plans

ACA mandates that plans offering insurance products on health benefit exchanges (HBE) maintain full accreditation with standards boards like NCQA or URAC. Generally considered the gold standard for accreditation, state Medicaid programs are increasingly adding NCQA compliance to their contracts with Medicaid MCOs. Traditionally exempt from NCQA’s Member Connections standards (MEM), Medicaid MCOs must now […]
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