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

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Comments of the Health <strong>Care</strong> Financing Administration (EHCFA) on
Office of Inspector General (OIG) Draft Revort.
"Retooling <strong>Medicaid</strong> Agencies for <strong>Managed</strong> <strong>Care</strong>." (OEI-01-95-00260)
OIG Recommendation I
HCFA should provide forams to help state <strong>Medicaid</strong> managers take advantage of the
opportunities managed care presents for retooling their agencies and to miiminze the
associated dangers.
HCFA Response
We concur. HCFA. in conjunction with the American Public Welfare Association
(APWA), already has in place several mechanisms that provide states an opportunity to
exchange lessons Icarned. As a result of this report HCFA is now cognizant of the need
to determine those states that have the greatest experience in moving from fee-for-service
to managed care environments (identified as Stage m in the report) and to encourage
those States to share their experiences with less advanced states through these existing
forums.
States may learn much about what works and what does not from states such as Oregon
and California. If HCFA Regional Offices were to develop local work groups on
managed care issues, most states would be able to handle issues unique to managed care
before the <strong>Medicaid</strong> managed care population climbs to over 50 percent nationwide.
OIG Recommendation 2
HCFA should revise its review and monitoring protocols so they devote greater attention
to how state <strong>Medicaid</strong> agencies are handling the organizational challenges associated with
expanded managed care.
HCFA Response
We concur. The OIG report acknowledges that the current readiness review guide for
section 1115 waivers contains a section on State administration with pertinent retooling
questions. We anticipate the ongoing review and revision of all of the monitoring
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