Medicaid Flexibility: Changes to Eligibility Determinations and Hearings.
This new law allows states to use outside contractors to speed up who qualifies for Medicaid. It aims to streamline the process but also sets rules to prevent these companies from delaying decisions or denying aid to eligible individuals. Importantly, these companies cannot have financial ties to Medicaid managed care organizations, preventing conflicts of interest.
Key points
States can now use external contractors or other government agencies to verify Medicaid eligibility, potentially speeding up the process.
Safeguards are in place to ensure these contractors are not incentivized to delay decisions or unfairly deny medical assistance.
Contractors handling eligibility cannot have financial ties to Medicaid managed care organizations, preventing conflicts of interest.
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