Summary Of Actuarial Review Of Minnesota Medicaid Managed Care Rate Setting

March 1, 2013
The Minnesota Department of Human Services contracted with the Segal Company to conduct a retroactive review of state rate setting for Medicaid managed care organizations (MCOs) between 2003 and 2011. The analysis found that from 2003 through 2011, Minnesota Medicaid overpaid its four MCO contractors by $162 million. The MCOs had profit margins of 3.1%, although the state rate setting calculations had projected a profit margin of 1.0%.
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