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CMS Updates Medicaid Managed Care Rate Guide

The Centers for Medicare & Medicaid Services (CMS) issued an informational bulletin July 1 that updates the 2016 Medicaid Managed Care Rate Development Guide. The guide, originally published in September 2015, serves as a resource for setting capitation rates for periods beginning in calendar year 2016.

Since initial release of the guide, CMS has published a Medicaid and Children’s Health Insurance Program (CHIP) Managed Care final rule, which contains provisions that impact the rate-setting process. The bulletin outlines provisions of the final rule that take effect on July 5, 2016, and the inclusion of new managed care requirements within states’ 2016 rate development.

Contact Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Gontscharow is a senior policy analyst for America's Essential Hospitals.