Medicaid Managed Care Options in Responding
to COVID-19 Medicaid Informational Bulletin

Medicaid.gov sent this bulletin at 05/14/2020 05:10 PM EDT


Today, the Centers for Medicare & Medicaid Services released
a new CMCS Informational Bulletin (CIB) to provide states
guidance on how to temporarily modify provider payment
methodologies and capitation rates under their Medicaid
managed care contracts to address the impacts of the
public health emergency while preserving systems of care
and access to services for Medicaid beneficiaries.
This guidance provides several options that states can
consider under their Medicaid managed care contracts,
including:

1. Adjusting managed care capitation
   rates exclusively to reflect temporary increases in Medicaid
   fee-for-service (FFS) provider payment rates where an approved
   state directed payment requires plans to pay FFS rates;
   
   
   
   
2. Requiring managed care plans
   to make certain retainer payments allowable under existing
   authorities to certain habilitation and personal care providers
   to maintain provider capacity and access to services; and
   
   
   
   
3. Utilizing state directed payments
   to require managed care plans to temporarily enhance provider
   payment under the contract.
   

In addition to the options described in this guidance, CMS will consider,
where appropriate, state requests to retroactively amend or implement
risk mitigation strategies only for the purposes of responding to the
COVID-19 pandemic.

The information released today furthers CMS’s commitment to providing
our state partners the resources they need during this public health emergency. 
This and earlier CMS actions in response to the COVID-19 crisis are all
part of ongoing White House Coronavirus Task Force efforts. To keep up
with the important work the Task Force is doing in response to COVID-19,
click here: www.coronavirus.gov. For a complete and updated list of CMS actions,
guidance, and other information in response to the COVID-19 virus, please visit
the Current Emergencies Website.  Additionally, CMS has launched a
dedicated, Medicaid.gov, COVID-19 resource page that will be continually
updated with relevant information.