On January 26, 2023, the Centers for Medicare & Medicaid Services approved California’s request to amend the California Advancing and Innovating Medi-Cal Section 1115 demonstration. This expert perspective describes the amendment, a centerpiece of which is approval for California Medicaid to provide a targeted set of Medicaid services to youth and adults in state prisons, county jails, and youth correctional facilities for up to 90 days prior to release. By providing re-entry services to Medicaid-enrolled individuals who are incarcerated, California aims to build a bridge to community-based care for justice-involved enrollees, offering them services to stabilize their physical and behavioral health conditions and establishing, prior to release, a re-entry plan for their community-based care.
Blueprint for Exchange Business Operations: Maryland Health Benefit Exchange
Wakely Consulting Group
This document, produced by Wakely Consulting, is intended to provide a high level overview of the business functions that must be established, the type of work that must be undertaken, and a relative timeline and chronological order for establishing the Maryland Health Benefit Exchange. This document is organized around 17 core work areas and coordinated around six primary business areas processes necessary for exchange implementation: Exchange Set Up, Core Systems, Communication & Outreach, QHP Plan Management, Risk Adjustment and Reinsurance, and Regulatory Compliance & Reporting. While the document does not represent the entire list of tasks and responsibilities that the Exchange will need to complete prior to 2014, it provides structure provides sufficient detail to allow key stakeholders and Exchange staff with a blueprint of the major business operation functions critical to successful implementation.