Susan M. Erickson opened the firm in 2015 in Austin, Texas, to provide legal services in the areas of managed care, Medicaid/CHIP managed care, health insurance regulatory, and general health care law. Ms. Erickson has more than 25 years of experience in these areas, gained during many years of practice with the insurance regulatory group of a major international law firm and as in-house general counsel to Texas' largest Medicaid managed care organization.
STAR Kids Implementation
HHSC has moved the implementation date for the STAR Kids Medicaid managed care program to November 1, 2016. The original implementation date had been set for September 1, 2016. STAR Kids will enroll approximately 180,000 Medicaid beneficiaries with disabilities and under the age of 21 in managed care companies selected through a competitive bidding process administered by the Texas Health and Human Services Commission, the state agency responsible for overseeing the Medicaid program.
Federal "Mega-Reg" Issued by CMS
On April 25, 2016, the Centers for Medicare and Medicaid Services (CMS) issued the Medicaid and CHIP Managed Care Final Rule. The set of regulations, which will be implemented in phases through 2018, cover a wide range of issues, including provider network adequacy, medical loss ratios, grievance and appeal processes, and quality rating systems. One of the primary purposes for the updates to the federal Medicaid managed care regulations (most of which are found at 42 CFR chp 438) was to bring more consistency among federal regulations affecting the Medicare Advantage programs, marketplace/Exchange programs, and Medicaid programs.
106 Dove Tail Ln.
Georgetown, TX 78628
Health Insurance and Managed Care Law
Medicaid Managed Care Law
General Health Care Law