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MAXIMUS Webinar Series

CMS Rule for Medicaid and CHIP Managed Care: What It Means for States

Recording | Slides

Final Rule on Medicaid and Children's Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revisions Related to Third Party Liability (CMS-2390-F).

The Centers for Medicare & Medicaid Services (CMS) just released a new rule affecting state Medicaid programs that use managed care organizations to deliver services to their beneficiaries. Among other provisions, the rule provides protections and support for managed care beneficiaries, validating and enhancing the role historically played by Medicaid enrollment brokers. While some state processes and systems support the rule, others will need to be adjusted or replaced to comply.

In this webinar, Medicaid experts cover:

  • Introduction to the Rule
    • Implementation timeframes
    • Overview of the changes from the proposed rule
  • General Beneficiary Supports
    • Choice counseling and other support for enrollment
    • Addressing health insurance literacy
    • Regulations regarding notices
    • Handling transitions of care
  • MLTSS Beneficiary Support Systems
    • Choice counseling for LTSS enrollment
    • Health plan notifications
    • Support for grievances and complaints
    • Ensuring assessments in a timely fashion
    • Transitions of LTSS for disenrollment cases
  • Meeting Compliance
    • Developing standard notices and handbooks
    • Overseeing plan and enrollment assistor compliance
    • Provider enrollment requirements

These experts also cover the evolution of Medicaid managed care and share how these rules will impact enrollment processing, choice counseling, consumer education and outreach, and LTSS.

Bruce L. Caswell, President, MAXIMUS

Kathleen Nolan, Managing Principal, HMA
Cathy Kaufmann, Managing Principal, HMA
Sharon Lewis, Principal, HMA
Heidi Robbins Brown, Principal, HMA

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