oversight

In a recently published issue brief, the National Association of Medicaid Directors (NAMD) provides an overview of Medicaid managed care. This brief covers the basics of what Medicaid managed care is, how it has grown over time, and how states and territories make decisions around delivery systems. It also dives into the core components of operationalizing managed care, including procurement, rate setting, and oversight. NAMD also discusses how Medicaid managed care is continuing to evolve, looking ahead at the potential impacts of market dynamics and regulatory changes on the quality, accessibility, and cost of care for Medicaid members.

The Leavitt Partners released a report reviewing the Medicaid non-emergency medical transportation (NEMT) benefit, focusing on the program integrity of the benefit. . The report examines challenges and opportunities for Medicaid directors in improving Medicaid NEMT program integrity.

Justice in Aging published an issue brief that offers an analysis of the findings from the evaluation of the Financial Alignment Initiative (FAI), commonly known as the dual eligible demonstration. Research Triangle Institute was contracted by the Centers for Medicare and Medicaid Services (CMS) to conduct this evaluation, which focused on the first six months of operation of the demonstration in each of the seven states where it was rolled out.

The Centers for Medicare & Medicaid Services (CMS) began the Financial Alignment Demonstration in 2013 to improve care coordination. GAO was asked to examine care coordination under this demonstration. On January 19, The Government Accountability Office publicly released a report with their recommendations for CMS. GAO recommends that CMS develop new measures and align the current measures to improve oversight of care coordination.

The United States Government Accountability Office (GAO) released a report on July 30, 2015, addressing key issues in Medicaid and the compilation of previous recommendations the office has made to the Centers for Medicare & Medicaid Services (CMS). The recommendations fall within four overarching areas of access to care, transparency and oversight, program integrity, and federal financing approach.

Adult day services (ADS)--a non-residential service provided outside an individual's home for less than a full day--provides direct care to older adults and younger adults with physical disabilities. This report provides information about each state's approach to regulating this key community service. The report details different models, forms of regulation, and funding sources used by states to run ADS programs.