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HHS/CMS RIN: 0938-AS25 Publication ID: Spring 2015 
Title: Medicaid Managed Care, CHIP Delivered in Managed Care, and Revisions Related to Third Party Liability (CMS-2390-P) 
Abstract:

This proposed rule would modernize the Medicaid managed care regulations to reflect changes in the usage of managed care delivery systems. The proposed rule would align the rules governing Medicaid managed care with those of other major sources of coverage, including coverage through Qualified Health Plans and Medicare Advantage plans; implement statutory provisions; strengthen actuarial soundness payment provisions to promote the accountability of Medicaid managed care program rates; ensure appropriate beneficiary protections and enhance expectations for program integrity. This rule would also implement provisions of the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) and addresses third party liability for trauma codes.

 
Agency: Department of Health and Human Services(HHS)  Priority: Economically Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: Yes  Unfunded Mandates: No 
EO 13771 Designation: uncollected 
CFR Citation: 42 CFR 430    42 CFR 431    42 CFR 438   
Legal Authority: 42 U.S.C. 1302   
Legal Deadline:  None
Timetable:
Action Date FR Cite
NPRM  05/00/2015 
Additional Information: Includes Retrospective Review under E.O. 13563.
Regulatory Flexibility Analysis Required: No  Government Levels Affected: Federal, State, Tribal 
Small Entities Affected: Businesses, Governmental Jurisdictions, Organizations  Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
Meg Barry
Health Insurance Specialist
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Medicaid and CHIP Services, MS S2-01-16, 7500 Security Blvd,
Baltimore, MD 21244
Phone:410 786-1536
Email: margaret.barry@cms.hhs.gov