Coverage decision-making in Medicaid managed care: key issues in developing managed care contracts.
Coverage provisions are the most complex part of any managed care contract. This is particularly true for Medicaid agencies, because of important differences between Medicaid and insurance. This Issue Brief identifies general issues that should be addressed by States as managed care contracts are developed and drafted, and it specifically explores the challenges faced by public purchasers when drafting managed care coverage provisions.
Rosenbaum
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Teitelbaum
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D003284:Contract Services / Q000331:legislation & jurisprudence; D006801:Humans; D019458:Insurance Coverage / Q000191:economics / Q000331:legislation & jurisprudence; D007348:Insurance, Health; D008329:Managed Care Programs / Q000331:legislation & jurisprudence; D008484:Medicaid / Q000331:legislation & jurisprudence; D008605:Mental Health Services / Q000191:economics / Q000331:legislation & jurisprudence; D013219:State Government; D013221:State Health Plans; D014481:United States