HHS to Delay and Loosen Medicaid Managed Care Rules
The Bush administration has chosen to delay and "soften" regulations issued during the final days of the Clinton administration that would provide a host of patient protections for Medicaid beneficiaries enrolled in managed care plans, the Washington Post reports. HHS officials plan to announce tomorrow that the "streamlined" revisions -- which one agency source calls "extensive" and which the Post reports come after an "intensive lobbying campaign" by health plans and state governments -- will grant states greater flexibility in how the protections are "carried out" while maintaining the "same broad categories" of safeguards. The rules, originally scheduled to take effect in April but delayed twice by the administration and now scheduled to be implemented sometime next year, offer patient protections similar to those found in patients' rights bills passed by the House and Senate earlier this year. Under the rules, Medicaid managed care beneficiaries would be granted guaranteed access to emergency room care and women's health services, and health plans would be required to provide easily understandable information and establish a grievance process for patients dissatisfied with their care. The regulations, however, would not give patients the right to sue their health plans, the main point of contention in the patients' rights debate in Congress (Goldstein, Washington Post, 8/15). Giving an example of how states would have greater "power over the details" of the rules, an HHS official said that states could now "set their own time frames under which a health plan had to review a patient complaint" (Meckler, Associated Press, 8/15).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.