MANAGED CARE February 1998. ©1998 Stezzi Communications
Once upon a time (and not so very long ago), state Medicaid directors had to apply to the Health Care Financing Administration for waivers before moving their beneficiaries into managed care. Now, instead of the waivers requirement, states will submit their managed care contracts to HCFA for review.
While this may seem to be only a cosmetic change, most Medicaid directors are reacting favorably. Contract review should be much easier than the cumbersome, time-consuming waiver process. HCFA still will enforce beneficiary protections, quality assurance standards and payment methods. It will expedite the process by reviewing draft or model managed care contracts and giving states an interim go-ahead to enroll beneficiaries and to conclude pacts with managed care organizations. Once a final contract is inked, a state can provide Medicaid managed care services.