Managed Care Resources

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Resources and Blogs 

 

  • Benefitsbloghttp://www.benefitscounsel.com/benefitsblog/ .   tax, benefits and ERISA law commentary authored by B. Janell Grenier, Esq. Ms. Grenier is principal of the Law Office of B. Janell Grenier, a Philadelphia-area law firm, and is licensed to practice in Pennsylvania, Utah, Missouri, and Oklahoma. Areas of practice: employee benefits, ERISA, qualified retirement plans, health plans, 125 plans, executive compensation, and ERISA fiduciary compliance. Ms. Grenier has been asked to comment on benefits issues, or has been quoted, by numerous national, regional and trade publications, 
  • Managed Care Matters; http://www.joepaduda.com . Joseph Paduda’s weblog on managed care for group health, workers compensation & auto insurance, covering health care cost containment, health policy, health research, and medical news for insurers, employers, and healthcare providers. Joe is the principal of Health Strategy Associates.

 

Arkansas 

  • Medicaid and Managed Care Program 

California 

  • Rand California– RAND California Medi-Cal Eligibility Statistics report the number of persons eligible by managed care program. Due to the implementation of HIPAA in April 2003 by the California Department of Health Services, county and five-digit zip code data is no longer released. This database is now searchable at the three-digit zip code level. The source is the California Department of Health Services.
  • Department of Industrial Relations. (Workers Comp) The Managed Care Program reviews applications from health care organizations and certifies them for the delivery of managed care services under California workers’ compensation law. Three types of organizations may apply for HCO certification: HMOs licensed by the Department of Managed Care Regulation; disability insurers licensed by the Department of Insurance; and other workers’ compensation health care provider organizations, otherwise known as WCHCPOs

Illinois 

Indiana 

  • Indiana Health Coverage Programs 

Maryland 

  • Health Choice HealthChoice is the name of the Maryland’s statewide mandatory managed care program which began in 1997. The HealthChoice Program provides health care to most Medicaid recipients. Eligible Medicaid recipients enroll in a Managed Care Organization (MCO) of their choice and select a Primary Care Provider (PCP) to oversee their medical care. The MCO enrollee selects a PCP who is part of their selected MCO’s provider panel either at the time of enrollment with the enrollment broker or once enrolled in their MCO.

Minnesota 

Nebraska 

New Jersey 

New York 

Tennessee 

  • Tenn Care TennCare is a government-operated health insurance program designed for people who are eligible for Medicaid, as well as for some children who do not have insurance. TennCare is a Medicaid waiver, or demonstration, program. Its purpose is to demonstrate that the use of managed-care principles can generate sufficient savings to enable the state to cover more than Medicaid eligible people.TennCare provides health coverage for 1.2 million low-income children, pregnant woman and disabled Tennesseans with an annual budget of $7 billion. 

Washington 

  • State Department of Social and Health Services 
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