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85% medical-loss ratio in final managed Medicaid rule
Modern Healthcare (complimentary online subscription): The CMS has finalized a long-awaited rule that will overhaul managed Medicaid, which has not been updated in a decade. The sweeping 1,425-page rule, which was proposed last May, caps insurer profits, requires states to more rigorously supervise the adequacy of plans' provider networks, encourages states to establish quality rating systems for plans, allows more behavioral healthcare in institutional settings and promotes the growth of managed long-term care.
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