Medicaid Managed Care: CMS’s Oversight of States’ Rate Setting Needs Improvement (GAO-10-810)

August 2010 The Government Accountability Office (GAO) assessed the Centers for Medicare and Medicaid Services (CMS) oversight of states’ compliance with the actuarial soundness requirements and efforts to ensure the quality of data used to set Medicaid managed care rates. GAO reviewed documents, including rate-setting review files, from 6 of CMS’s 10 regional offices. The selected offices oversaw 26 of the 34 states with comprehensive managed care programs; the states’ programs varied in size and accounted for over 85% of managed care enrollment. Download the Report . . .