NHeLP2012

Since the 1980s, the National Health Law Program (NHeLP) has studied and monitored Medicaid managed care at the federal, state, and local levels. As of 2011, nearly 75 percent of Medicaid beneficiaries received services through some type of managed care arrangement — and that proportion is surely higher in 2015. Making Medicaid managed care work is therefore crucial to ensuring that the program lives up to its commitment to meeting the needs of the nation’s most vulnerable. In this publication, NHeLP attorneys have drawn upon decades of experience to support stakeholders as they embark on, or continue to engage in, Medicaid managed care work. NHeLP’s Guide to Oversight, Transparency, and Accountability in Medicaid Managed Care provides a robust set of tools, tips, and techniques to obtain information about states’ Medicaid managed care programs. It explains how advocates, beneficiaries, and others can use this information to ensure that managed care companies and state Medicaid agencies are fulfilling their obligations to enrollees and to taxpayers