State Guidance on Claiming Methodologies for Medicaid Managed Care (SMD 23-005)
The purpose of this letter is to provide guidance on claiming Federal Financial Participation (FFP)
for Medicaid managed care expenditures through capitation payments. In certain circumstances, a
portion of a capitation payment should be matched with FFP at a “differential match rate” that varies
from the standard Federal Medical Assistance Percentage (FMAP) for each state that is established
in section 1905(b) of the Social Security Act (the Act).
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 10, 2023
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.