Managed Care | Medicaid
Managed Care is a health care delivery system organized to manage cost, utilization, and quality. Medicaid managed care provides for the delivery of Medicaid health benefits and additional services …
Medicaid and CHIP Managed Care Final Rules
Nov 9, 2020 · 2024 Medicaid and CHIP Managed Care Final Rule On April 22, 2024, CMS put on display at the Federal Register the Medicaid and Children’s Health Insurance Program Managed …
State Managed Care Quality Strategies | Medicaid
Federal regulations at 42 CFR § 438.340 for Medicaid, and through a cross-reference at § 457.1240 (e) for separate CHIP, lay the groundwork for the development and maintenance of a state managed …
Managed Care Entities | Medicaid
Federal Managed Care regulations at 42 CFR 438 recognize four types of managed care entities:Managed Care Organizations (MCOs)Comprehensive benefit packagePayment is risk …
Guidance | Medicaid
Managed care technical assistance is available to assist state Medicaid agencies in developing, enhancing, implementing, and evaluating managed care programs. Final Rules CMS has updated …
Profiles & Program Features | Medicaid
These Managed Care State Profiles and State Program Features reflect the most recently available managed care program information.
Managed Care Authorities | Medicaid
Regardless of the authority, states must comply with the federal regulations that govern managed care delivery systems. These regulations include requirements for a managed care plan to have a quality …
Introduction The Centers for Medicare & Medicaid Services (CMS) is releasing the 2025-2026 Medicaid Managed Care Rate Development Guide for use in setting rates for rating periods starting between …
Managed Care in Pennsylvania This profile reflects state managed care program information as of August 2014, and only includes information on active federal operating authorities, and as such, the …
National tables provide summary data on Medicaid managed care enrollment at the state, program, and managed care plan level, as well as program features including type of enrollment (mandatory or …