The recently passed healthcare reform law has generated much uncertainty among Medicaid professionals about what implications it will have for their programs’ members, services, providers, resources, and regulatory requirements. Opinions diverge widely on the law’s impact, especially its financial impact on administrators, providers, and consumers of healthcare. Although much of the impact remains to be seen, Medicaid enrollment is expected to mount as the federal government funds newly eligible members, a basic healthcare package will become available, program funding will be adjusted, and states will modify some aspects of their Medicaid program administration. The spike in Medicaid enrollment may create challenges for Medicaid administrators and providers as they seek to serve this burgeoning population. In response to this, providers may need to increase their capacity, while administrators may need to restructure their provider networks, take steps to bolster their financial stability, implement enhanced anti-fraud measures, and plan for the simultaneous federal push for health IT meaningful use. States and possibly local governments will need to plan for their additional responsibilities under healthcare reform and consider how to handle these as they address changes resulting from other federal initiatives, such as HIPAA 5010. The federal government will need to provide further guidance to ensure that services, policies, and operations do not vary excessively from state to state. All stakeholders should be proactive in preparing for the implementation of the healthcare reform provisions.
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