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Tag: Medicaid Managed Care


OIG: States not reporting accurate managed care data 

March 31, 2021HME News Staff

WASHINGTON - Most states did not provide complete or accurate payment data on managed care payments to the CMS Transformed Medicaid Statistical Information System (T-MSIS), which provides oversight of the Medicaid program, according to a recent report from the Office of Inspector General.  The data include the amounts paid, billed and allowed for every service provided to Medicaid enrollees, including those services provided through managed care, the primary delivery system for...

Medicaid Managed Care, T-MSIS

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GAO: MCOs need more oversight

June 7, 2018HME News Staff

WASHINGTON - CMS should take steps to mitigate program risks in managed care, according to a new report from the Government Accountability Office.About 0.3% of the $171 billion that Medicaid paid managed care organizations for 2017 was improper, the GAO found.CMS's estimate of improper payments for managed care has limitations that are not mitigated by current oversight efforts, the GAO says. One component of the Payment Error Rate Measurement measures the accuracy of capitated payments made to MCOs....

Medicaid Managed Care

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