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December 14, 2017
Today's Featured Story
In Reconsidering Medicaid Managed Care Regulations, CMS Favors ‘Outcome Over Process’
CMS this year began implementing portions of its landmark Medicaid managed care rule — the first major update to the program since 2002 — including a key provision that states include requirements for managed care plans to calculate and report a medical loss ratio (MLR). But in a March letter from CMS Administrator Seema Verma and then-HHS Secretary Tom Price, M.D., encouraging states to seek waiver authority to innovate within their Medicaid programs, they promised to conduct a “full review of managed care regulations in order to prioritize beneficiary outcomes and state priorities.”...  Read Full Story
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Today's AIS Health Datapoint
46.32% ... of the New Jersey managed Medicaid market is served by Horizon Blue Cross Blue Shield. It operates the largest managed Medicaid plan in New Jersey, and the ninth largest in the nation.

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