{
  "id": "R44105",
  "type": "CRS Report",
  "typeId": "REPORTS",
  "number": "R44105",
  "active": false,
  "source": "EveryCRSReport.com",
  "versions": [
    {
      "source": "EveryCRSReport.com",
      "id": 451101,
      "date": "2015-07-15",
      "retrieved": "2016-04-06T22:44:54.040058",
      "title": "Centers for Medicare & Medicaid Services (CMS) Proposed Rule on Medicaid Managed Care: Frequently Asked Questions",
      "summary": "On May 26, 2015, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule (CMS-2390-P) laying out the agency\u2019s plan to update the federal regulations pertaining to Medicaid managed care, under which states contract with private health insurers to provide health care to some enrollees. The proposed rule was posted to the Federal Register on June 1, 2015. \nThe proposed rule would be the first major federal regulation impacting Medicaid managed care since 2002. In the early 1990s, states began turning to managed care to deliver benefits to enrollees. In FY2011, 49.8% of Medicaid enrollees were enrolled in comprehensive risk-based managed care. Many states rely on managed care organizations (MCOs) to deliver services to individuals newly eligible for Medicaid under the Patient Protection and Affordable Care Act\u2019s (ACA\u2019s; P.L. 111-148, as amended) Medicaid expansion. The proposed rule would influence how states structure their managed care programs going forward. As of September 2014, 39 states had contracted with MCOs to deliver care to their Medicaid enrollees. Because of the high percentage of Medicaid enrollees receiving benefits through managed care, the proposed rule likely would impact millions of Medicaid enrollees. With so many people receiving Medicaid services through managed care, CMS is updating the regulations to better align them with today\u2019s health care landscape, including the recent changes to Medicare Advantage and the private health insurance market (including the introduction of health insurance exchanges) as a result of the ACA. \nThis report responds to a series of frequently asked questions (FAQs) identified to address some of the major updates included in the proposed rule. The FAQs summarize provisions such as the introduction of a minimum medical loss ratio (MLR), guidance on enrolling the long-term services and supports (LTSS) population in managed care, and network adequacy. This report is not meant to be comprehensive and does not include all of the numerous technical changes CMS outlines in the proposed rule. Instead, this report provides a high-level summary of some of the major provisions in the proposed rule.\nCMS is taking public comments on the proposed rule through July 27, 2015. Once the comment period closes, CMS will review the comments and make any changes before preparing a final rule. This report may be updated to include additional FAQs or more detailed answers on certain aspects of the proposed rule.",
      "type": "CRS Report",
      "typeId": "REPORTS",
      "active": false,
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      "topics": []
    }
  ],
  "topics": [
    "Health Policy"
  ]
}