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Medicaid Managed Care

Medicaid managed care regulations govern how states contract with managed care organizations (MCOs) to deliver Medicaid benefits. Most states now enroll the majority of their Medicaid population in managed care. These rules establish requirements for network adequacy, enrollee rights, quality, grievances, and rate setting.

Citation: 42 C.F.R. Part 438
Sections: 106
Words indexed: 73,148
Applies to: State Medicaid agencies, managed care organizations (MCOs), prepaid inpatient health plans (PIHPs), and prepaid ambulatory health plans (PAHPs)

Key Points

States must ensure managed care networks are adequate to provide timely access to covered services

Enrollees have the right to file grievances and appeals with their MCO, plus a state fair hearing

MCOs must meet quality assessment and performance improvement requirements

Capitation rates must be actuarially sound and approved by CMS

States must provide enrollees with plan choice and the ability to change plans

Key Areas

Network Adequacy

Provider network requirements, access standards

Enrollee Rights

Grievances, appeals, information requirements

Quality

Quality assessment, external review, performance measures

Key Provisions

438.206

Network Adequacy

MCOs must maintain a network sufficient in number, mix, and geography to provide adequate access. This is the most common compliance issue in Medicaid managed care.

438.228

Grievance and Appeal Systems

Detailed requirements for how MCOs handle member grievances and appeals. Strict timelines and notification requirements.

All Regulation Sections

Part 438Managed Care(106)