Managed Care Plans as Critical Partners in Implementing New Medicaid Program Requirements

Manatt Health Partner and Managing Director co-authored an article for American Health Law Association examining how Medicaid managed care plans can support states as they implement new eligibility, enrollment and cost-sharing requirements under recent federal legislation.

In the article, Montz and Serafi explore four critical areas where managed care plans are uniquely positioned to partner with states: supporting work and community engagement requirements, strengthening renewal and redetermination processes, tracking incurred cost sharing, and addressing provider fraud, waste and abuse. They explain how leveraging plans’ existing data, infrastructure and member relationships can help mitigate administrative burden, reduce coverage loss and promote program integrity.

“States will face significant challenges operationalizing these new Medicaid program changes, particularly given the complexity of the requirements, tight implementation timelines, and existing eligibility and enrollment workforce constraints. Managed care plans can work in partnership with states to help mitigate administrative burden, reduce coverage loss of eligible individuals, and strengthen program integrity,” wrote the authors.

Read the full American Health Law Association article .