And earlier this year, the GAO reiterated those concerns, saying that CMS needed to “continue taking steps to improve oversight” of Medicaid managed care rate-setting.
Howell, the Urban Institute researcher, said their study also found gaps in federal monitoring.
“We saw unevenness in both how the rates are set and in the federal oversight of the state’s oversight,” she said. “The requirements are there,” she said, “but they’re not evenly enforced in (CMS’) regional offices.”
CMS would not make an official available to comment for this story, instead issuing a statement saying it is committed to working with states to give them flexibility in administering their programs.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.
Wed, Jul 03 2013