Radar on Medicare Advantage

New CMS Bulletin Could Mean Greater Oversight of Medicaid Network Adequacy

  • Jul 21

    Jul 21, 2022

    CMS in a recent bulletin unveiled a “suite of new resources” aimed at guiding states and CMS in their oversight of Medicaid and CHIP programs, including managed care programs. Two items of particular interest to managed care organizations in a July 6 Center for Medicaid and CHIP Services Informational Bulletin (CIB) are templates that provide a standard format for states to report managed care medical loss ratios and network adequacy to determine how well a plan actually delivers its benefits. As plans struggle to meet network adequacy standards, the new template could lead to more intense oversight of network adequacy within managed care, industry experts suggest. Read more
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    • Lauren Flynn Kelly

    Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.

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Meet Our Reporters

Lauren Flynn Kelly

Executive Editor, AIS Health, and Managing Editor, Radar on Medicare Advantage

View Lauren Flynn Kelly's Profile

Angela Maas

Managing Editor, Radar on Specialty Pharmacy and Spotlight on Market Access

View Angela Maas's Profile

Leslie Small

Managing Editor, Health Plan Weekly and Radar on Drug Benefits

View Leslie Small's Profile

Carina Belles

Reporter, Radar on Medicare Advantage and Spotlight on Market Access

View Carina Belles's Profile

Jinghong Chen

Reporter, Health Plan Weekly and Radar on Drug Benefits

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Jill Drachenberg

Reporter, Health Plan Weekly and Radar on Drug Benefits

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