Medicaid Managed Care: States' Safeguards for Children with Special Needs VarySignificantly

摘要

This report is the second of a two-part study we conducted at your request. Thefirst report examined the BBA definition of children with special needs and described the limited data available about their participation in Medicaid managed care. It also assessed steps taken by the Department of Health and Human Services (HHS) Health Care Financing Administration (HCFA) to establish safeguard criteria for these children in the agencys waiver review and approval process. This report (1) presents data on the extent to which states are enrolling children with special needs, as defined in the BBA, in capitated managed care plans and (2) assesses the scope and effectiveness of the safeguards these states are implementing to ensure that children with special needs receive appropriate care within Medicaid managed care.