Community Health Plans Ask HHS For Assist On Medicaid Capitation Rates

The lobby representing community-based health plans is asking HHS for an assist in its efforts to ensure state payments to Medicaid managed care organizations reflect a sicker risk pool post-redetermination and reflect other issues that raise costs, including high-cost drugs like GLP-1s and new sickle cell therapies. Specifically, the Alliance of Community Health Plans says HHS must encourage states to adjust 2024 rates -- and develop rates for 2025 -- based on the most recent usage data; HHS officials must...