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Medicaid Managed Care: Quality Oversight Support for State Quality Strategy and External Review Processes

The Centers for Medicare and Medicaid Services (CMS) is pleased to announce the availability
of new resources for Medicaid managed care oversight. As of 2012, 39 states, the District of
Columbia, and Puerto Rico contract with either a Medicaid managed care organization (MCO) or
a prepaid inpatient health plan (PIHP) to provide medical or behavioral health care to at least half
of the approximately 60 million Medicaid beneficiaries.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: November 19, 2012

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.