Medicaid Managed Care Final Rule: Implications for Missouri

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In April 2016, the Centers for Medicare and Medicaid Services (CMS) issued a final rule on managed care in both Medicaid and the Children’s Health Insurance Program (CHIP). Regulations covering Medicaid managed care had not been changed since 2002, when only 58 percent of the Medicaid population was enrolled in a managed care plan. As of March 2016, 38 states and the District of Columbia have contracts with managed care organizations (MCOs) to deliver care to some portion of their state’s Medicaid recipients. There are approximately 72 million beneficiaries in Medicaid across the nation, and an estimated 48 million are enrolled in a Medicaid managed care plan.