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- 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 package Payment is risk-based capitation Primary Care Case Management (PCCM)
- Managed Care in Pennsylvania - Medicaid. gov
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 program available to most Medicaid beneficiaries in certain counties in 1972
- Managed Care in Puerto Rico - Medicaid. gov
Managed Care in Puerto Rico This profile reflects state managed care program information as of August 2021, and only includes information on active federal operating authorities, and as such, the program start date may not reflect the earliest date that a program enrolled beneficiaries and provided services Some states report populations and services available to program participants under
- Managed Care in Arizona - Medicaid. gov
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 start date may not reflect the earliest date that a program enrolled beneficiaries and provided services Some states report populations and services available to program participants under the
- Drug Utilization Review Annual Report | Medicaid
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 operations, including adoption of new innovative DUR practices via the Medicaid Drug Utilization Review Annual Report Survey Please visit the Drug Utilization Review page for more inf
- Rate Review and Rate Guides | Medicaid
The managed care regulation requires that states develop valid managed care capitation rates in accordance with generally accepted actuarial principles and practices
- Managed Care in Illinois - Medicaid. gov
Managed Care in Illinois 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 start date may not reflect the earliest date that a program enrolled beneficiaries and provided services Some states report populations and services available to program participants under the
- Managed Care in Colorado - Medicaid. gov
Colorado has used both MCO and PCCM managed care delivery models for over three decades Its longest currently running program, the Managed Care Organization (MCO) program, began in 1983, and now covers acute, primary, and specialty services to Medicaid beneficiaries in Denver County and surrounding areas
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