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Medicare and Medicaid

New Lewin Report Shows Need for National Medicaid Out-of-Network Claims Policy

Published in Healthcare Mergers, Acquisitions and Ventures Week, August 1st, 2009

The Lewin Group released a new report assessing the financial impact and administrative burden that out-of-network claims pose in Medicaid managed care. The authors of the report recommend a federally mandated payment standard for Medicaid health plans similar to that used in the Medicare Advantage managed care program.

The report, "Medicaid Non-Emergency Out-of-Network Payment Study," was commissioned by Medicaid Health Plans of America (MHPA) and the Association for Community Affiliated Plans (ACAP). The report examined Medicaid non-emergency out-of-network payment policies in Arizona, California, Florida, Georgia, Maryland, Nebraska, New Jersey, New York,...

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