Understanding Medicaid Managed Care Procurement Practices Across States

In April 2022, the Medicaid and CHIP Payment and Access Commission conducted an analysis of the Medicaid procurement process to better understand how the managed care contracting process affects service delivery and achievement of policy goals. The commission reviewed federal statutes, rules, and guidance; conducted an environmental scan of Medicaid managed care procurements over a five-year period, including interviews with the Centers for Medicare & Medicaid Services (CMS), state Medicaid officials, managed care organizations (MCOs), policy experts, and consumer advocates; and examined managed care procurement processes to identify gaps and opportunities in current CMS oversight . . .