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 …
Drug Utilization Review Annual Report | Medicaid
May 29, 2025 · On an annual basis, states are required to report on their practitioners prescribing habits, cost savings generated from their Drug Utilization Review (DUR) programs and their program’s …
Pennsylvania began experimenting with various managed care arrangements in the 1970’s, beginning with the introduction of its Voluntary Managed Care Program, a comprehensive risk-based MCO …
Participating Plans, Plan Selection, and Rate Setting The state contracted with three health plans to manage care for beneficiaries. Three plans, Coventry Cares of Kentucky, Anthem Health Plan, and …
Managed Care in Arizona 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 program …
CHIP Managed Care | Medicaid
In July 2018, we developed a guide covering the standards that are used by the Centers for Medicare & Medicaid Services (CMS) staff to review state contracts with CHIP managed care organizations …
Medicaid and CHIP Managed Care Reporting
CMS has also created a web-based reporting portal for these reports, thereby creating a single submission process and repository for all state reporting requirements related to managed care. The …
New York Managed Care Program Features, as of 2021 (1 of 2)
Overview of Current Managed Care Programs In 2011, all Medicaid beneficiaries in Tennessee were enrolled managed care. Tennessee began its Medicaid managed care program, TennCare, in 1994. …
Medicaid and CHIP Managed Care Quality
Many states deliver services to Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries via managed care arrangements. Federal regulations at 42 CFR 438 for Medicaid, and incorporated …