1. NASDDDS Federal News
Briefs
February 17th, 2012
____________________________________________________
NCD Sends Managed Care Recommendations and
Principles to CMS
The National Council on Disability (NCD) has sent a letter with specific recommendations
regarding the implementation of Medicaid managed care for individuals with disabilities to the
Centers for Medicare and Medicaid Services (CMS), accompanied by a set of twenty detailed
guiding principles for “Successfully Enrolling People with Disabilities in Managed Care Plans.”
NCD sent the recommendations to articulate the implications of managed care arrangements in
publically financed service systems for individuals with disabilities, and offer suggestions to
address these issues. The paper identifies the key issues that must be addressed as state
delivery systems move to managed care arrangements and makes a series of recommendations
to improve the success of system change efforts in states nationwide. The attached principles
articulate a set of guidelines that NCD says “must be meticulously observed in designing and
carrying out managed care initiatives involving people with chronic disabilities” in order to ensure
that they reap the benefits of a managed care environment and do not become “the victims of
poorly conceived and executed public policies that fail to meet their needs.” NCD contracted with
the National Association of State Directors of Developmental Disabilities Services (NASDDDS) to
develop both the recommendations and the principles, as well as a forthcoming white paper on
Medicaid managed care for people with disabilities, as part of pursuing their efforts to inform
decision-makers on both the strengths and weaknesses of the managed care approach for this
population as managed care-based Medicaid reforms sweep the country.
The recommendations document, “Analysis and Recommendations for the Implementation of
Managed Care in Medicaid and Medicare Programs for People with Disabilities,” offers an
“assessment of the impact of managed care on people with disabilities to identify the
opportunities and strengths to build on as well the weaknesses and risks that must be mitigated in
pursuing managed care as a component of health care reform.” Following this, NCD provides
suggestions that focus on CMS’s role in assessing state readiness, with a detailed list of factors
the agency should consider, and on CMS’s role in approving state contracts with managed care
entities, including specific elements that NCD must require in the contracts.
In the principles document, NCD says it “recognizes that managed care techniques can create a
pathway toward higher quality services and more predictable costs, but only if service delivery
policies are well designed and effectively implemented, and achieve cost savings by improving
health outcomes and eliminating inefficiencies, not by reducing the quality or availability of care.”
The principles document is meant to provide a clear set of guidelines that states and CMS can
use to steer the development of these policies. The principles address personal experience and
outcomes, designing and managing a managed care system, managed care operating
components, and participants’ rights.
FMI: The recommendations to CMS are available at
http://www.nasddds.org/pdf/CMSMANAGEDCARENCDRECOMMENDATIONS 1.pdf. The
Guiding Principles are available at
http://www.nasddds.org/pdf/MANAGEDCARENCDPRINCIPLES 1.pdf.