{"abstract":"This final rule with comment period amends the Medicaid regulations to implement provisions of the Balanced Budget Act of 1997 (BBA) that allow the States greater flexibility by permitting them to amend their State plan to require certain categories of Medicaid beneficiaries to enroll in managed care entities without obtaining waivers if beneficiary choice is provided; establish new beneficiary protections in areas such as quality assurance, grievance rights, and coverage of emergency services; eliminate certain requirements viewed by State agencies as impediments to the growth of managed care programs, such as the enrollment composition requirement, the right to disenroll without cause at any time, and the prohibition against enrollee cost-sharing. In addition, this final rule expands on regulatory beneficiary protections provided to enrollees of prepaid health plans (PHPs) by requiring that PHPs comply with specified BBA requirements that would not otherwise apply to PHPs.","action":"Final rule with comment period.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Health Care Financing Administration","name":"Health Care Finance Administration","id":559,"url":"https://www.federalregister.gov/agencies/health-care-finance-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/559","parent_id":221,"slug":"health-care-finance-administration"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2001/01/19/01-1447.html","cfr_references":[{"chapter":null,"citation_url":null,"part":400,"title":42},{"chapter":null,"citation_url":null,"part":430,"title":42},{"chapter":null,"citation_url":null,"part":431,"title":42}],"citation":"66 FR 6228","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"Effective Date: These regulations are effective on April 19, 2001. Provisions that must be implemented thorough contracts with managed care organizations, prepaid health plans, health insuring organizations, or enrollment brokers are effective with respect to contracts that are up for renewal or renegotiation on or after April 19, 2001, but no longer than April 19, 2002.","disposition_notes":null,"docket_ids":["HCFA-2001-FC"],"dockets":[],"document_number":"01-1447","effective_on":"2001-04-19","end_page":6426,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2001/01/19/01-1447.xml","html_url":"https://www.federalregister.gov/documents/2001/01/19/01-1447/medicaid-program-medicaid-managed-care","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/01-1447?publication_date=2001-01-19","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2001-01-19/01-1447/mods.xml","not_received_for_publication":null,"page_length":199,"page_views":{"count":2466,"last_updated":"2026-10-23 14:15:06 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2001-01-19/pdf/01-1447.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":null,"publication_date":"2001-01-19","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2001/01/19/01-1447.txt","regulation_id_number_info":{"0938-AI70":{"issue":"200010","html_url":"https://www.federalregister.gov/regulations/0938-AI70/medicaid-managed-care-regulatory-program-to-implement-certain-medicaid-provisions-of-the-balanced-bu","title":"Medicaid Managed Care; Regulatory Program To Implement Certain Medicaid Provisions of the Balanced Budget Act of 1997 (HCFA-2001-F)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=200010&RIN=0938-AI70&operation=OPERATION_EXPORT_XML","priority_category":"Other Significant"}},"regulation_id_numbers":["0938-AI70"],"regulations_dot_gov_info":{"checked_regulationsdotgov_at":"2011-02-27T17:06:00Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":6228,"subtype":null,"title":"Medicaid Program; Medicaid Managed Care","toc_doc":"Managed care","toc_subject":"Medicaid:","topics":[],"type":"Rule","volume":66}