Medicaid Managed Care - U.S. Senate Special Committee on Aging

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For each state, we reviewed the contractual and other requirements the
states have established with plans for these selected accountability
indicators. We also interviewed officials from the state <strong>Medicaid</strong>. health,
and insurance agencies to discuss specific contract requirements with
managed care plans, state oversight activities and state actions available
or taken as a result of monitoring, and state plans for changes in and
expansions to their managed care programs.
To identify federal requirements and guidance available to states to
oversee their <strong>Medicaid</strong> managed care programs, we interviewed officials
from HCFA'S central office and Chicago and Philadelphia regional offices.
the Department of Health and Human Services' (HHS) Office of Inspector
General, and state-level advocacy groups. We also interviewed experts
with The George Washington University Center for Health Policy
Research, the National Association of <strong>Managed</strong> <strong>Care</strong> Regulators, the
National <strong>Committee</strong> on Quality Assurance, and the National Association of
Insurance Commissioners. Finally, we consulted with the following
experts and researchers in the course of our work: Jane Horvath. National
Academy for State Health Policy, Washington, D.C.; Robert Hurley,
Medical College of Virginia, Richmond, Virginia; and Stephen Somers and
Karen Brodsky, Center for Health Strategies. Princeton, New Jersey.
We performed our work between October 1995 and March 1997 in
accordance with generally accepted government auditing standards.
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