A thoughtful procurement and contracting approach may assistance align stakeholder, state and MCO expectations before the deal begins, ensure readiness, and stay away from afterwards challenges. Louisiana’s design contract consists of detailed descriptions of both equally state company and MCO responsibilities through the readiness review procedure in the event the condition is analyzing whether the MCO is ready to start functioning.

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In 2023, the Facilities for Medicare and Medicaid Providers proposed new rules on prior authorization, managed care obtain, finance and top quality, amount transparency and high quality requirements that could lead to substantial updates to point out oversight responsibilities in Medicaid managed care when applied.

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Texas recognized continuity of care prerequisites for MCOs that serve beneficiaries with sophisticated clinical wants, so that these beneficiaries could continue on to obtain care from specialty providers that are not in-network Using the new Medicaid MCO.  

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Oregon has 16 distinct MCOs, Each individual responsible for a single geographic service region, Even though some MCOs serve in more than one geographic region. Beneficiaries are immediately assigned to your MCO for that services place and the MCOs will not contend in opposition to one another for beneficiaries.

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