NASDDDS Federal News Briefs February 17th, 2012 ____________________________________________________NCD Sends Managed Care Recommendations and Principles to CMSThe National Council on Disability (NCD) has sent a letter with specific recommendationsregarding the implementation of Medicaid managed care for individuals with disabilities to theCenters for Medicare and Medicaid Services (CMS), accompanied by a set of twenty detailedguiding principles for “Successfully Enrolling People with Disabilities in Managed Care Plans.”NCD sent the recommendations to articulate the implications of managed care arrangements inpublically financed service systems for individuals with disabilities, and offer suggestions toaddress these issues. The paper identifies the key issues that must be addressed as statedelivery systems move to managed care arrangements and makes a series of recommendationsto improve the success of system change efforts in states nationwide. The attached principlesarticulate a set of guidelines that NCD says “must be meticulously observed in designing andcarrying out managed care initiatives involving people with chronic disabilities” in order to ensurethat they reap the benefits of a managed care environment and do not become “the victims ofpoorly conceived and executed public policies that fail to meet their needs.” NCD contracted withthe National Association of State Directors of Developmental Disabilities Services (NASDDDS) todevelop both the recommendations and the principles, as well as a forthcoming white paper onMedicaid managed care for people with disabilities, as part of pursuing their efforts to informdecision-makers on both the strengths and weaknesses of the managed care approach for thispopulation as managed care-based Medicaid reforms sweep the country.The recommendations document, “Analysis and Recommendations for the Implementation ofManaged 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 theopportunities and strengths to build on as well the weaknesses and risks that must be mitigated inpursuing managed care as a component of health care reform.” Following this, NCD providessuggestions that focus on CMS’s role in assessing state readiness, with a detailed list of factorsthe agency should consider, and on CMS’s role in approving state contracts with managed careentities, including specific elements that NCD must require in the contracts.In the principles document, NCD says it “recognizes that managed care techniques can create apathway toward higher quality services and more predictable costs, but only if service deliverypolicies are well designed and effectively implemented, and achieve cost savings by improvinghealth 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 canuse to steer the development of these policies. The principles address personal experience andoutcomes, designing and managing a managed care system, managed care operatingcomponents, and participants’ rights.FMI: The recommendations to CMS are available athttp://www.nasddds.org/pdf/CMSMANAGEDCARENCDRECOMMENDATIONS 1.pdf. TheGuiding Principles are available athttp://www.nasddds.org/pdf/MANAGEDCARENCDPRINCIPLES 1.pdf.